Senate Hearings Before the Committee on Appropriations

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S. HRG. 111–688 Senate Hearings Before the Committee on Appropriations

Department of Defense Appropriations

Fiscal Year 2011

111th CONGRESS, SECOND SESSION

S. 3800

DEPARTMENT OF DEFENSE NONDEPARTMENTAL WITNESSES Department of Defense Appropriations, 2011 (S. 3800) S. HRG. 111–688 DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

HEARINGS BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE ONE HUNDRED ELEVENTH CONGRESS

SECOND SESSION

ON S. 3800

AN ACT MAKING APPROPRIATIONS FOR THE DEPARTMENT OF DEFENSE FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2011, AND FOR OTHER PURPOSES

Department of Defense Nondepartmental Witnesses

Printed for the use of the Committee on Appropriations (

Available via the World Wide Web: http://www.gpo.gov/fdsys

U.S. GOVERNMENT PRINTING OFFICE 54–962 PDF WASHINGTON : 2010

For sale by the Superintendent of Documents, U.S. Government Printing Office, http://bookstore.gpo.gov. For more information, contact the GPO Customer Contact Center, U.S. Government Printing Office. Phone 202–512–1800, or 866–512–1800 (toll-free). E-mail, [email protected]. COMMITTEE ON APPROPRIATIONS DANIEL K. INOUYE, Hawaii, Chairman ROBERT C. BYRD, West Virginia THAD COCHRAN, Mississippi PATRICK J. LEAHY, Vermont CHRISTOPHER S. BOND, Missouri TOM HARKIN, Iowa MITCH MCCONNELL, Kentucky BARBARA A. MIKULSKI, Maryland RICHARD C. SHELBY, Alabama HERB KOHL, Wisconsin JUDD GREGG, New Hampshire PATTY MURRAY, Washington ROBERT F. BENNETT, Utah BYRON L. DORGAN, North Dakota KAY BAILEY HUTCHISON, Texas DIANNE FEINSTEIN, California SAM BROWNBACK, Kansas RICHARD J. DURBIN, Illinois LAMAR ALEXANDER, Tennessee TIM JOHNSON, South Dakota SUSAN COLLINS, Maine MARY L. LANDRIEU, Louisiana GEORGE V. VOINOVICH, Ohio JACK REED, Rhode Island LISA MURKOWSKI, Alaska FRANK R. LAUTENBERG, New Jersey BEN NELSON, Nebraska MARK PRYOR, Arkansas JON TESTER, Montana ARLEN SPECTER, Pennsylvania

CHARLES J. HOUY, Staff Director BRUCE EVANS, Minority Staff Director

SUBCOMMITTEE ON DEFENSE DANIEL K. INOUYE, Hawaii, Chairman ROBERT C. BYRD, West Virginia THAD COCHRAN, Mississippi PATRICK J. LEAHY, Vermont CHRISTOPHER S. BOND, Missouri TOM HARKIN, Iowa MITCH MCCONNELL, Kentucky BYRON L. DORGAN, North Dakota RICHARD C. SHELBY, Alabama RICHARD J. DURBIN, Illinois JUDD GREGG, New Hampshire DIANNE FEINSTEIN, California KAY BAILEY HUTCHISON, Texas BARBARA A. MIKULSKI, Maryland ROBERT F. BENNETT, Utah HERB KOHL, Wisconsin SAM BROWNBACK, Kansas PATTY MURRAY, Washington ARLEN SPECTER, Pennsylvania

Professional Staff CHARLES J. HOUY NICOLE DI RESTA KATE FITZPATRICK KATY HAGAN KATE KAUFER ELLEN MALDONADO ERIK RAVEN GARY REESE BETSY SCHMID BRIDGET ZARATE STEWART HOLMES (Minority) ALYCIA FARRELL (Minority) BRIAN POTTS (Minority) BRIAN WILSON (Minority) Administrative Support RACHEL MEYER

(II) CONTENTS

WEDNESDAY, MARCH 3, 2010

Page Department of Defense: Department of the Army: Office of the Secretary ...... 1

WEDNESDAY, MARCH 10, 2010 Department of Defense: Medical Health Programs ...... 65

WEDNESDAY, MARCH 17, 2010 Department of Defense: Department of the Navy: Office of the Secretary ...... 173

WEDNESDAY, MARCH 24, 2010 Department of Defense: National Guard ...... 235 Reserves ...... 291

WEDNESDAY, APRIL 21, 2010 Department of Defense: Missile Defense Agency ...... 337

WEDNESDAY, MAY 12, 2010 Department of Defense: Department of the Air Force: Office of the Secretary .. 365

WEDNESDAY, JUNE 16, 2010 Department of Defense: Office of the Secretary ...... 409

WEDNESDAY, JUNE 23, 2010 Nondepartmental Witnesses ...... 473

(III)

DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, MARCH 3, 2010

U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 9:31 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) presiding. Present: Senators Inouye, Dorgan, Shelby, and Brownback. DEPARTMENT OF DEFENSE

DEPARTMENT OF THE ARMY

OFFICE OF THE SECRETARY STATEMENTS OF: HON. JOHN M. McHUGH, SECRETARY GENERAL GEORGE W. CASEY, CHIEF OF STAFF

OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. The hearing will come to order. This morning, we welcome the Honorable John McHugh, Sec- retary of the Army, along with General George Casey, the Chief of Staff of the United States Army. Gentlemen, we thank you for being here with us today as we review the Army’s budget request for fiscal year 2011. Before proceeding, I’d like to announce that, because of illness, the vice chairman will not be with us this morning. In his place, we have the gentleman from Alabama. The Department of the Army’s fiscal year 2011 budget request is $143.4 billion, an increase of $2.5 billion over last year’s enacted budget, excluding funding appropriated to the Army in the fiscal year 2010 supplemental. The Army also has requested $20 billion for overseas contingency operations for the remainder of this fiscal year, primarily to fund surge operations in Afghanistan. In April of last year, President Obama and Secretary Gates announced substantial initiatives within the Department of Defense to strengthen our All-Volunteer Force, change how and what the Department buys, and rebalance military capabilities. After an overhaul of the Army’s modernization effort last year, fiscal year 2011 budget request includes $3.2 billion for the Army’s (1) 2 revamped Brigade Combat Team Modernization Program and provides $6 billion for Army aviation. The fiscal year 2011 budget request builds upon the reform agenda set by Secretary Gates last year and supports the final year of a 5-year plan to restore balance to an Army that has experienced the cumulative effects of years upon years of conflict. The subcommittee is looking forward to hearing not only about these efforts, but also about the Department’s vision to rebalance and reshape, as directed in the Quadrennial Defense Review (QDR) completed this past January. One of the central themes of the 2010 Quadrennial Defense Review is balance. The Department needs to find balance between providing capabilities to prevail in today’s wars, while building the capabilities needed to counter future threats. The Army is shouldering a very heavy burden, since it has been conducting combat operations in two theaters while transforming and modernizing at the same time. However, budget pressures to support current operations have made it very difficult to allow for the investment in modernization. Not only is balance included and needed between meeting the demands of today and the threats of the future, it is also needed within each of the military services, and the Army has continued to answer the Nation’s call, but it has been at the expense of maintaining a well-balanced force. We are aware of the demands created by more than 8 years of continuous war. Repeated and lengthy deployments have stressed our soldiers, their families, and our support systems and equipment. Currently the Department is managing a shift in focus in our overseas contingency operations. While the withdrawal of U.S. forces from Iraq has begun, an additional 30,000 troops have been committed to supporting operations in Afghanistan. Since the Army is the service most heavily engaged in these operations, the Secretary of Defense has permitted the Army to retain 22,000 soldiers, temporarily, above the authorized end strength of 547,000. This decision was made to acknowledge the fact that future readiness is dependent upon restoring balance and lessening the strain upon the force. Finally, there is one other type of balance that this subcommittee will be looking for during the budget review, the balance between risk and resources. The Quadrennial Defense Review has set the agenda and defined requirements, and presumably the Department has budgeted for those priorities. However, there will never be enough resources to eliminate all risk. It is our hope that today’s hearing will help illuminate how the Army’s fiscal year 2011 budget request addresses the recommendations of the Quadrennial De- fense Review while maintaining balance among a number of valued, yet equally important, priorities. Gentlemen, we sincerely appreciate your service to our Nation and your dedication and sacrifices made daily by the men and women in our Army. We could not be more grateful for what those who wear our Nation’s uniform do for our country each and every day. Gentlemen, your full statements will be made a part of the record. And I would now wish to turn to the Senator from Alabama. 3

STATEMENT OF SENATOR RICHARD C. SHELBY Senator SHELBY. Thank you, Mr. Chairman. I’ll be brief. I just want to join you in welcoming Secretary McHugh and General Casey to this subcommittee. They’re no strangers here. Thank you. Chairman INOUYE. I thank you very much. Now, with that, Secretary, we are depending on you, sir. SUMMARY STATEMENT OF HON. JOHN MC HUGH Mr. MCHUGH. Thank you very much, Mr. Chairman. As you noted, we’ll enter, with your permission, our full statements into the record. And I know time is of some concern here this morning, so I just would like to summarize a few of those points. First of all, I want to, at the risk of stating the obvious, say what an honor it is to be here today. I had the distinct honor of serving for 17 years on the House Armed Services Committee, and in that time I gained a great appreciation for the great work this subcommittee does, for the enormous support that it has, historically, and certainly under the leadership of you, the vice chairman, and the current members, have continued in support of not just our Army, but all of our services. I certainly want to take this opportunity to express my personal appreciation and thanks for all that you do, and all that you will continue to do. If I may, Mr. Chairman, just a few comments on my now 5 months as the 21st Secretary of the Army. And while it’s been a crash course of learning, I think some things are obvious. And I would add, Mr. Chairman, in listening to your opening comments, I think you’ve encapsulated very well the key questions, the key challenges that lie before us. As you’ve said, Mr. Chairman, and as I have seen from the first day I walked into that hallowed building on the other side of the Potomac, this is an Army that clearly is fatigued, is stressed by nearly 9 years of combat. But, it is still an Army that is amazingly resilient, that is amazingly effective. Today, as you know, this is an Army that has more expertise, more education, it has more capability and lethality than any Army in our Nation’s history. That is, in no small measure, because of the great support and leadership that has come out of this great subcommittee. Those are significant gains, but, in spite of those gains, this is, quite simply, an Army that is, and remains, out of balance. The Chief of Staff—General Casey—and my predecessor, Pete Geren, the Army leadership, along in partnership with the Congress have made great progress in bringing that balance back. I think, one of the key assets and key attributes of the President’s proposed budget is that it allows us to continue the regaining of balance, and, in fact, should allow us to finish it. But, this is a very delicate balance, and we need to stay focused on that objective. You noted, Mr. Chairman, the variety of appropriations that take us toward that goal, the $1.7 billion in requests to continue to fund our vital family programs in support of those amazing families, and other initiatives. I won’t continue to repeat those, but a couple of other points, I think, do bear noting. 4 We remain extraordinarily committed to our wounded warriors. Tomorrow, I will have the opportunity to pay my regular visit to Walter Reed, and I know what I will see. I will see a cadre of individuals who have stepped forward, who have given more in their time on the battlefield than most Americans could possibly imagine, and who will ask one simple question, ‘‘What can I do to serve more?’’ We recognize the obligation we have to provide world-class transition, world-class healthcare services to those heroes. This budget provides us with that opportunity and allows us to go forward in that solemn obligation. It also allows us to do something very important, in terms of recapitalizing, rebalancing, and modernizing our equipment systems that require those kinds of adjustments. And, as you noted, Mr. Chairman, that’s a significant challenge under the best of circumstances, but clearly, at time of war, becomes even more problematic. But, with your support, we will continue to do that. The funding is there—$3.1—$31.7 billion in research and development, brigade combat team modernization funds, et cetera, et cetera. The other thing—and it’s something that this Congress recognized last year—that we need help in is acquisition reform. I think it’s necessary to give our acquisition people, who have also been at war for nearly 9 years, their due. Over the last 10 years, they’ve had a 15-percent cut in personnel and a 500-percent increase in their dollars to bring under contract. And in spite of that, in that time, 1,000 protests brought against the decisions that they made, and only 8 of those 1,000 protests upheld. Still, they would be the first to recognize they need help. We need to continue to redevelop the acquisition rules and regulations to allow us to be more effective in support of the warfighter, and, equally important, more efficient in support of our taxpayer dollars. We look forward in engaging with this Congress, with this great subcommittee, in bringing that about. PREPARED STATEMENT In the end, I would tell you, we have an Army that is strong in spirit, it is strong in ability and in results. But, as I said in my opening comments, and as you noted, Mr. Chairman, it is an Army that is greatly stressed. We can do better by them. We feel that’s our obligation and what this budget brings to the table and allows us the opportunity to do. And, in partnership with you, we look forward to pursuing that very worthy goal. With that, Mr. Chairman, I’d yield back. Chairman INOUYE. I thank you very much, Mr. Secretary. [The statement follows:]

PREPARED STATEMENT OF JOHN M. MCHUGH AND GENERAL GEORGE W. CASEY, JR.

INTRODUCTION America’s Army continues to answer the Nation’s call, as it has since it was established nearly 235 years ago. Today our Army is fighting two wars, assisting other nations as they build their own security capacity, supporting civil authorities at home, helping the people of Haiti rebuild after a devastating earthquake, and preparing to deter and defeat new threats. The Army’s Soldiers, Civilians, and Families faithfully shoulder the load that our Nation asks of them. With the support of the Congress, we are on track with our 4-year plan to put the Army back in balance. 5

Though their sacrifices can never be fully repaid, the Nation continues to recognize and honor our Soldiers and their Families by supporting them before, during, and following deployments. Our Soldiers rely upon the best training and equipment that our Nation can provide to accomplish their mission. Yet even with this continued support, the demands of 8 years of war weigh heavily on our Army. The strain of multiple deployments is evident on Soldiers and their Families. Equipment is used at a pace that seriously challenges our maintenance and replacement capabilities and resources. The stress is present in our institutions as we change 20th century systems and processes to meet the demands of the 21st century. Our Nation faces the difficult challenge of balancing when, where, and how to engage in a dynamic and uncertain world while meeting important priorities at home. However, when the security of our citizens or allies is threatened, the Nation can depend on America’s Army—the Strength of the Nation.

STRATEGIC CONTEXT The United States faces a complex strategic landscape with an array of diverse security challenges. We are fighting wars in Iraq and Afghanistan while preparing for future challenges to our national security. For the foreseeable future, violent extremist movements such as Al Qaeda and other terrorist organizations comprise the most immediate threats. Current global economic conditions, changes in demographics, cultural pressures associated with globalization, and competition for scarce resources exacerbate the uncertainty and volatility of the strategic environment. Within this setting, the American Soldier stands as our Nation’s most visible and enduring symbol of commitment in an era of persistent conflict.

PERSISTENT CONFLICT For the near future, persistent conflict—protracted confrontation among state, non-state, and individual actors that are increasingly willing to use violence to achieve their political and ideological ends—will characterize the global security environment. Security crises will arise unpredictably, vary in intensity and scope, and last for uncertain durations. These challenges will take place in all domains: land, sea, air, space, and cyberspace. Natural disasters and humanitarian emergencies will continue to be frequent and unpredictable missions, requiring the commitment of Soldiers and resources. In this dynamic environment, the Army will conduct operations that span the spectrum of conflict from humanitarian and civil support to counterinsurgency to general war, often simultaneously.

GLOBAL TRENDS Several global trends will continue to shape the international security environment and the conflicts confronting our Nation. Globalization may increase prosperity, but it can also spread destabilizing influences. The unequal distribution of benefits creates societies with divisions between ‘‘haves’’ and ‘‘have nots’’—divisions that can be exploited by extremist ideologies and lead to conflict. Fault lines reflecting protracted competition and friction can erupt unpredictably as societies struggle to adjust to the move toward modernity and greater interdependence. Meanwhile, increasingly available and affordable technology provides our adversaries sophisticated tools to enable a networked approach to recruiting the disenfranchised and exporting terror. Shifting demographics and rapid population growth that is increasingly urbanized can continue to break down traditional, localized norms of governance, behavior, and identity, and further strain already stressed governments. This is especially true where a lack of economic opportunity increases the potential for instability and extremism. Those who are disaffected may rebel against perceived Western interference, challenges to traditional values, and ineffective governments. Increased resource demand, in particular energy, water, and food, is a consequence of growing prosperity and populations. The growing global competition for resources will continue to produce friction and increase opportunities for conflict. In this environment, climate change and natural disasters will compound already difficult conditions in developing countries by igniting humanitarian crises, causing destabilizing population migrations, and raising the potential for epidemic diseases. The two trends of greatest concern are the proliferation of weapons of mass destruction (WMD) and failed or failing states. A catastrophic attack utilizing WMD has the potential to be globally destabilizing. Failed or failing states, lacking the will or capacity to maintain effective territorial control, contribute to regional instability and provide ideal environments for terrorist groups to plan and export operations. The merging of these two trends constitutes a significant and compelling threat. Together, these trends make conflict in the decades ahead more likely. 6

CHARACTER OF CONFLICT IN THE 21ST CENTURY Global trends and recent conflicts—such as those in Lebanon and Georgia—and our own recent combat experience indicate the evolving character of conflict in the 21st century. Conflicts will be waged among diverse actors—state and non-state—with the latter employing capabilities that, during the last century, remained largely the purview of nation-states. Motives, objectives, and often the identities of these actors will be difficult to discern, and are likely to shift as some act covertly and others use proxies. The battle to gain influence over, and support from, populations will be central to our success. Therefore, conflict will be unavoidably waged among the people. The initiation, location, duration, and intensity of conflicts are increasingly unpredictable. In an interdependent world, conflicts are more susceptible to the potential for spillover, creating regionally, and potentially globally, destabilizing effects. All of this will occur under the unblinking scrutiny of the 24-hour global media cycle and the Internet. Details of conflict as well as misinformation will flow equally across social, communications, and cyber networks. Our adversaries will exploit these media and communication sources locally and globally. We are more likely to face hybrid threats—diverse and dynamic combinations of conventional, irregular, terrorist, and criminal capabilities employed asymmetrically to counter our advantages. Hybrid threats require hybrid solutions—adaptive military forces that can function in a variety of situations with a diverse set of national, allied, and indigenous partners. Given the strategic environment, enduring global trends, and the character of 21st century conflict, the Army will operate as part of a Joint, interagency, inter-governmental, and multi-national team to fulfill its global commitments.

ROLES OF LAND FORCES More than one million of our men and women have served in the ongoing campaigns in Iraq and Afghanistan. Over 3,900 American Soldiers have given their lives, and more than 25,000 others have been wounded during this longest period of sustained conflict ever fought by an all-volunteer force. Today, America’s Army has over 255,000 Soldiers and more than 18,500 Army Civilians serving in nearly 80 countries around the world—with the remainder stationed within the United States supporting domestic missions, resetting from recent deployments, or preparing for an upcoming deployment. Our Soldiers are performing magnificently around the world every day, and the roles for land forces in this environment are becoming increasingly clear. First, the Army must prevail in protracted counter-insurgency (COIN) operations. Not only must we prevail in our current missions in Iraq, Afghanistan, and the Phil- ippines, we must be prepared to prevail in any future COIN operation. Second, the Army must engage to help other nations build capacity and to assure our friends and allies. Through security force assistance, we can increase the capacity of other nations’ military and police to uphold the rule of law, ensure domestic order, and deny sanctuary to terrorists—thereby helping avoid future conflicts that might otherwise develop. American Soldiers are currently deployed to Central Amer- ica and the Balkans, building the capacity of indigenous security forces. Addition- ally, the Army has established an Army Service Component Command for U.S. Afri- ca Command to assist partner nations and humanitarian organizations in Africa. A third role that the Army fulfills is to provide support to civil authorities at home and abroad. In the past year alone, American Soldiers have fought fires in the west, conducted search and rescue operations in the Rockies and Alaska, and assisted with tsunami relief in American Samoa, in support of civil authorities. The Army has also provided a sizeable force to support the relief efforts in Haiti following the catastrophic earthquake that destroyed its capital. Army units from both the active and reserve components remain prepared to react to a variety of crises as consequence management and response forces. The U.S. Army Corps of Engi- neers is a lead organization in providing DOD support to civil authorities for disaster relief at home and engineering support to USAID overseas. Abroad, the Army has also supported civil authorities in many ways, such as sending Agribusiness De- velopment Teams from the Army National Guard to Afghanistan. Finally, the Army must deter and defeat hybrid threats and hostile state actors. As an Army, we recognize that we must remain prepared to meet and defeat hostile state actors that threaten our national security. But we recognize that the probability of facing a nation that will challenge America’s military head-on is lower than it was during the Cold War and other periods in our history. Our readiness and capability to confront near-peer competitors also deters war by raising the stakes for nation-state and hybrid actors who would threaten our security interests. 7

To meet these threats, Army units continue to participate in Joint and international training exercises around the world, ensuring that military skills and cooperative partnerships remain strong. The Army continues to position forces in Korea and at various missile defense sites in order to discourage actors who seek to disrupt regional stability and security.

TWO CRITICAL CHALLENGES The Army has operated at a demanding pace for the last 8 years, and while it has met each challenge, the strain has placed the Army out of balance. Demand for Army forces continues to exceed the sustainable supply. Against that backdrop, the Army continues to meet the wartime requirements of our Nation while it addresses the two major challenges facing our force—restoring balance and setting conditions for the future. In 2007, we established a 4-year plan to restore balance to an Army that had experienced the cumulative effects of years of conflict. The fiscal year 2011 budget supports the final year in that plan. As we continue to restore balance to the force, we are also setting the conditions for the Army of the 21st century—an Army that fulfills our strategic role as an integral part of our Joint Force.

RESTORING BALANCE: THE ARMY’S FOUR IMPERATIVES With the help of Congress, we have made significant progress over the past 3 years in our plan to restore balance—a plan founded on four imperatives. Yet today the Army remains out of balance. We’ve improved our ability to sustain the Army’s Soldiers, Families, and Civilians; prepare forces for success in the current conflict; reset returning units to rebuild the readiness consumed in operations and to prepare for future deployments and contingencies; and transform to meet the demands of the 21st century. As a result of this progress we now are in a better position to achieve balance than we were 2 years ago. Critical to this was the growth in the size of the Army. The security agreement with Iraq that transferred security in urban areas to Iraqis was a momentous and welcomed accomplishment. The hard work and sacrifice of our Soldiers with the support of Congress helped make this achievement possible and set the conditions for our responsible drawdown of combat forces in Iraq this year. Coupled with our growth, the drawdown in Iraq allowed for our increased commitment of forces to Afghanistan to stem the rising violence, and disrupt, dismantle, and defeat al-Qaeda while reversing the momentum of the Taliban insurgency. However, the campaigns in Iraq and Afghanistan continue to create demands that have our Army operating beyond sustainable capacity. In fact, in 2009 more Soldiers were deployed in Iraq and Afghanistan combined than during the height of the Iraq surge. Presently, and for the short term, we lack sufficient strategic flexibility, and we continue to accumulate risk. We continue to stress our Soldiers, Families, Civilians, equipment, and institutional systems, so our efforts to restore balance must not waiver. Sustain Sustaining our all-volunteer force is our first imperative. Nowhere is the stress on our force more profound than in the toll it takes on our people, as is tragically evident in the rising number of suicides and increasing need for counseling among our Soldiers and Families. We are aggressively addressing the causes of stress on individuals resulting from the cumulative effects of multiple deployments, and seeking to build resilience in Soldiers, Families and Civilians. The Army is committed to ensuring that the quality of life of those who serve the Nation is commensurate with the quality of their service. Goals To sustain the force, the Army continues to pursue four major goals. Our first goal is to Recruit and Retain quality Soldiers and Civilians dedicated to service to the Nation. Next, we are committed to furnishing the best Care, Support, and Services for Soldiers, Families, and Civilians by improving quality of life through meaningful initiatives such as the Army Family Action Plan, the Army Family Covenant, Army Community Covenants, and the Comprehensive Soldier Fitness Program. It is our solemn obligation to provide world-class Warrior Care and Transition to our wounded, ill, and injured Warriors through properly led and resourced Warrior Transition Units. Finally, by Supporting the Families of our Fallen Comrades we honor their service and sacrifice. 8

Progress and Accomplishments The Army met 104 percent of its recruiting goals for 2009, and achieved both nu- meric goals and quality benchmarks for new recruits. All components exceeded 105 percent of their reenlistment goals. We reduced off-duty fatalities by 20 percent, to include a 15 percent reduction in overall privately-owned-vehicle fatalities and 37 percent reduction in motorcycle fatalities. In collaboration with the National Institute of Mental Health, the Army began a seminal study into suicide prevention that will inform the Army Suicide Prevention Program and society’s approach to suicide. We began instituting Comprehensive Soldier Fitness—an all-inclusive approach to emotional, social, spiritual, family, and physical fitness—as the foundation to building resiliency within the Army. We initiated an unprecedented series of construction projects at five major hospitals as part of our commitment to modernize our healthcare system. The Army established the Warrior Transition Command and reorganized Warrior Transition Brigades to provide centralized support, rehabilitation, and individualized transition planning to our recovering Warriors. We expanded Survivor Outreach Services to over 26,000 Family members, providing unified support and advocacy, and enhancing survivor benefits for the Fami- lies of our Soldiers who have made the ultimate sacrifice. We implemented the Post 9/11 GI Bill, significantly increasing educational benefits for active duty Soldiers, Veterans, and Family members. The Army Reserve established Army Strong Community Centers to support geographically-dispersed Soldiers and Families. Together with Army National Guard Family Assistance Centers and Soldier and Family Assistance Centers on active duty installations, these centers provide help to Soldiers’ Families near their home- towns. Fiscal Year 2011 Budget Highlights Provides $1.7 billion to standardize and fund vital Family programs and services to include welfare and recreation; youth services and child care; Survivor Outreach Services; and expanded education and employment opportunities for Family members. Provides a 1.4 percent military basic pay raise and Civilian pay raise, a 3.9 percent basic allowance for housing increase, and a 3.4 percent basic allowance for subsistence increase. Warrior Transition Units for our wounded Soldiers will continue to receive strong support in fiscal year 2011 with $18 million in Military Construction funds allocated to resource construction of barracks spaces. Supports Residential Communities Initiatives program, which provides quality, sustainable residential communities for Soldiers and their Families living on-post, and continues to offset out-of-pocket housing expenses for those residing off-post. Prepare Our Soldiers face determined enemies—so preparing the force for our current conflict is complex and time-consuming, but essential for success. Our units must have the people, training, and equipment they need to prevail. Meanwhile, our institutions and systems must adapt to provide those critical capabilities in a timely manner and in sufficient quantities. Goals To prepare the force, we have four key goals. First, we accelerated the pace at which we needed to Grow the Army to our end strength and to grow our modular brigades to 73 Brigade Combat Teams (BCTs) and nearly 230 Support Brigades. Second, the Army is committed to improving individual and collective Training to better prepare Soldiers and leaders for a complex and challenging operational environment. Next, we continuously work to provide our formations with effective Equipment in a timely manner that maintains our technological edge and protects our most critical resource—the Soldier. Finally, we must transform the Army to a rotational model—Army Force Generation (ARFORGEN)—the core process for generating trained, ready, and cohesive units on a sustained and rotational basis—to meet current and future strategic demands. Progress and Accomplishments We began the phase-out of stop-loss, starting with the Reserve Component in Au- gust 2009 and the Army National Guard in September 2009, and followed by the Active Army in January 2010. Today, no mobilizing or deploying units have stop- loss Soldiers in their ranks. 9

The force achieved its ‘‘Grow the Army’’ end strength goal of 1.1 million in 2009. The active component continues to grow toward its additional authorized Temporary End Strength in order to improve unit manning within the already existing Army structure as we eliminate stop-loss. Fifteen month tours effectively ended in November 2009, when the last Soldiers on those extended deployments returned. We completed fielding nearly 12,000 Mine Resistant Ambush Protected (MRAP) vehicles in Iraq and Afghanistan and delivered the first MRAP All-Terrain Vehicles (M–ATVs) to Afghanistan—just 15 months after identifying the need for that capability. As of the beginning of February, we have provided nearly 800 M–ATVs to Afghanistan. This year, we successfully manned, trained, equipped, and deployed 67 brigade equivalents. The Army exceeded fleet readiness of 90 percent for ground equipment, to include MRAPs, and 75 percent for aviation. We established Army Training Network (ATN)—a 21st Century Approach to Army Training. This revolution in training knowledge access is now providing a one- stop portal to share training best practices, solutions, and products across the Army. The Army increased its employment of biometric technologies enabling the Army to better identify the enemy among the populace. Fiscal Year 2011 Budget Highlights Funds permanent, active component end strength at 547,400; Army Reserve at 205,000; and National Guard at 358,200 in the base budget and supports a 22,000 temporary increase in the active component through the Overseas Contingency Op- erations (OCO) request. Procures and upgrades the Army’s UH–60 Black Hawk, CH–47 Chinook, and AH– 64 Apache helicopters, which are vital to operations in Afghanistan and Iraq. Provides over $1 billion for flight crew training in all components to fund flying hours, maintenance, fuel, airfield operations, and specialized skill training. Reset With the pace of continuous combat operations in two wars for the past 8 years, we are consuming our readiness as fast as we can build it. Reset restores returning units—their Soldiers, Families, and equipment—to a level of readiness necessary for future missions. Goals Our Reset plans include four goals. Our efforts to Revitalize Soldiers and Families seek to reestablish and strengthen relationships following deployments. The Army’s comprehensive efforts to Repair, Replace, and Recapitalize Equipment affected by the harsh environments of the war are essential to resetting units. In particular, achieving responsible drawdown in Iraq while increasing our commitment of forces and equipment to Afghanistan will require an unprecedented reset effort. The Army must Retrain Soldiers, Leaders, and Units to build critical skills necessary to operate across the spectrum of conflict in the current security environment. Lastly, we are identifying and applying the lessons learned from the Reset Pilot Program that was designed to improve the efficiency and effectiveness of the Reset process. Army Reset is a necessary process that must continue not only as long as we have forces deployed, but an additional two to three years after major deployments end. Progress and Accomplishments The Army completed the reset of 29 brigades’ worth of equipment in fiscal year 2009 and continued the reset of 13 more. In total, we have reset more than 98,000 pieces of equipment as depot production has doubled since September 11, 2001. We began executing a responsible drawdown in Iraq which will redistribute, transfer, or dispose of 3.4 million pieces of equipment; redeploy 143,000 military and Civilian personnel, and 147,000 contractors; close 22 supply support activities; and consume or dispose of over 21,000 short tons of supplies. In 2009, more than 160,000 Soldiers and Family members participated in over 2,600 Strong Bonds events designed to strengthen Army Families. The Army continues to revise its approach to training by emphasizing doing fewer tasks better, making judicious use of field time, and maximizing the use of mobile training teams and distributed learning. We completed our Reset Pilot Program and will begin instituting the full Reset model across the Army in 2010. The Army fostered partnerships by executing more than $24 billion in new foreign military sales. 10

Fiscal Year 2011 Budget Highlights Provides $10.8 billion to reset Army equipment through the Overseas Contingency Operations (OCO) request. Supports training and sustainment of Army forces to include individual skills and leader training; combined arms training toward full spectrum operations; and adaptable, phased training based on the ARFORGEN process. Transform Since 2004, the Army has been transforming our force to provide the combatant commanders tailored, strategically responsive forces that can dominate across the spectrum of conflict. Transformation is a continuous process that sets the conditions for success against both near-term and future enemies. Goals Our goals for transformation include continued Modular Reorganization to standardize our formations to create a more deployable, adaptable, and versatile force. We will accelerate fielding of Advanced Technologies to ensure our Soldiers retain their technological edge. The Army will Operationalize the Reserve Components by systematically building and sustaining readiness while increasing predictability for these Soldiers, Families, employers, and communities. Completing the requirements of the Base Realignment and Closure (BRAC) statutes is central to Restationing Forces. Soldier and Leader Development will ensure that we produce the next generation of agile and adaptive military and Civilian leaders who are supremely competent in their core proficiencies and sufficiently broad enough to operate effectively in the Joint, interagency, intergovernmental, and multi-national environments. Progress and Accomplishments The Army is 88 percent complete on the modular conversion of its brigades. The fiscal year 2011 budget will support the near completion of this process. The Army consolidated existing aviation force structure to create a 12th active component combat aviation brigade (CAB) forming an additional deployable CAB without adding force structure. The Army activated the 162nd Infantry Brigade at Fort Polk, Louisiana, providing a dedicated and enduring capability to prepare combat advisors to train and build capacity in foreign security forces. Trainers from the brigade are now deployed to Afghanistan to assist with the training and development of the Afghan Security Forces. The Army developed a new incremental capability package approach to modernization which will allow technologically mature, Soldier-tested, proven technologies to be prioritized, bundled in time, and fielded to the force more quickly than ever before. We provided combatant commanders with dedicated, regionally based network operations support, and integrated cyber security capability in the form of Theater Network Operations and Security Centers, unique within the Department of De- fense. This past year, the Army closed three active installations and five U.S. Army Re- serve Centers and is on course to complete BRAC in fiscal year 2011. To date, we have awarded 265 major military construction projects, of which 59 are complete. The Army built a Leader Development Strategy that balances experience, greater opportunities for professional education, and training in full spectrum operations. Fiscal Year 2011 Budget Highlights Invests nearly $3.2 billion in BCT modernization programs that include procurement of the first incremental changes packages for Infantry BCTs and additional research, development, testing, and evaluation funding for subsequent change packages as well as initial development of the Ground Combat Vehicle (GCV). Provides funds to begin equipping a 13th Combat Aviation Brigade. Supports the increase in ISR platforms to include the Extended Range/Multi-Pur- pose, Raven, Shadow unmanned aerial vehicles (UAVs) and the Extended Medium Altitude Reconnaissance and Surveillance System.

SETTING CONDITIONS FOR THE FUTURE 21st Century Army The second critical challenge facing the Army is setting the conditions for the future through a continuous process of transformation. We must ensure that our Na- tion has the capability and range of military options to meet the evolving challenges we face in the 21st century. We need an Army that is a versatile mix of tailorable 11 and networked organizations, operating on a rotational cycle, to provide a sustained flow of trained and ready forces for full spectrum operations and to hedge against unexpected contingencies—at a tempo that is predictable and sustainable for our all-volunteer force. Versatility is the central organizing principle of a balanced Army. It enables our forces and institutions to effectively execute operations across the spectrum of conflict. Our modular heavy, Stryker, and light brigades provide a versatile mix of forces that can be combined to provide multi-purpose capabilities, and sufficient capacity to accomplish a broad range of tasks from peacetime engagement to major combat operations. Our modular units are designed to be tailorable. Brigades now have capabilities previously found at division level and higher. These brigades can be tailored for specific missions and combined with support units and key enablers such as ISR, communications, civil affairs, psychological operations, public affairs capabilities, and expanded logistics support, to accomplish a wide variety of missions and increase the land options available to combatant commanders. The network is essential to a 21st century Army. Networked organizations improve the situational awareness and understanding leaders need to act decisively at all points along the spectrum of conflict, while providing connectivity down to the individual Soldier. The network allows dispersed Army organizations to plan and operate together, and provides connectivity to Joint, combined, and interagency assets. To support this objective, the Army will use the Global Network Enterprise Construct (GNEC) as our strategy to transform LandWarNet to a centralized, more secure, operationalized, and sustainable network capable of supporting an expeditionary Army. To provide a sustained flow of trained and ready forces at a tempo sustainable for our all-volunteer force, we will put the whole Army under a rotational model— ARFORGEN. The ARFORGEN process includes three force pools—Reset, Train-Ready, and Available. Each of the three force pools contains a versatile force package, available at varying time intervals based on its readiness level. Each force pool consists of an operational headquarters (a corps), five division headquarters (of which one or two are National Guard), twenty brigade combat teams (three or four are National Guard), and 90,000 enablers (about half of those are Guard and Reserve). Each will be capable of full spectrum operations once we reach a steady-state, ratio of time deployed (known as ‘‘boots on the ground’’ or BOG) to time at home (dwell) of 1:2 (BOG:dwell) for active component forces and 1:4 for reserve component forces. This versatile mix of land forces could sustain operations in Iraq and Afghanistan. At lower demand levels, a sustainable BOG:dwell ratio of 1:3 for active component forces and 1:5 for reserve component forces provides ready, global reaction forces and regionally-oriented forces for engagement in support of Theater Security Co- operation Programs. This process also allows strategic flexibility to surge in response to unexpected contingencies across the spectrum of conflict, and provides operational depth with more forces available for longer commitment times. The increased demands of our combatant commanders, coupled with the size of our active component (AC) force, require that we continue to integrate reserve component (RC) forces as part of our operational force. Continued and routine access to our RC forces is essential to sustaining current operations, and is improving the overall operational experience and quality of our RC forces. Additionally, sufficient Army National Guard (ARNG) forces must be ready and immediately available to their state and territorial authorities to respond to domestic crises. We are building an integrated Army in which our RC forces are included in the rotational cycle, but at a deployment rate of about half that of their AC counterparts. The ARFORGEN process increases predictability for Soldiers, Families, employers, and communities, and enables our RC to remain an integral element of the operational force while providing the Nation with the strategic depth (i.e. those non- deployed units which are 2 to 3 years from commitment) and operational flexibility to meet unexpected contingencies. The Army has undergone significant changes in recent years, and we must continue to change in order to keep pace with an environment of uncertainty and complexity in this era of persistent conflict. The same requirements that drive the imperative to change also drive our modernization efforts and need for institutional adaptation. Realizing Change To become the Army the Nation needs in the second decade of the 21st century, we are transforming the Army and prioritizing programs and efforts that show the most promise for today and tomorrow. Similarly, we are transforming business proc- 12 esses across the Army, including how we identify requirements, acquire, and provide materiel capabilities to our Soldiers, and how we adapt our institutions to align with the ARFORGEN process. On April 6, 2009, Secretary Gates announced his adjustments to the defense program as part of the President’s budget proposal for fiscal year 2010. The Secretary’s decisions had an immediate and major impact on our FCS-centric Army modernization effort. He terminated the MGV portion of FCS, directing that we ‘‘reevaluate the requirements, technology, and approach—and then re-launch the Army’s vehicle modernization program. . . .’’ He further directed the Army to ‘‘accelerate the initial increment of the program to spin out technology enhancements to all combat brigades,’’ and retain and deliver software and network development program in increments, and incorporate MRAP into our force structure. Secretary Gates’ intent for these bold adjustments was clear—to better reflect the lessons that we were learning from ongoing operations and better posture Army forces for a broader range of future challenges. To fully implement the Secretary of Defense’s direction, the Army has developed a comprehensive plan. We refer to this new program as the Army’s ‘‘Brigade Combat Team Modernization Plan,’’ which is a subset of our overall Army Modernization Strategy. BCT Modernization Plan We will leverage the lessons learned from the last 8 years to provide effective and affordable equipment now, while reducing the time it takes to develop and field new and updated materiel solutions. BCT Modernization includes four elements: modernizing the network over time to take advantage of technology upgrades, while simultaneously expanding it to cover ever increasing portions of the force; incorporating MRAPs into our force; rapidly developing and fielding a new Ground Combat Vehi- cle that meets the requirements of the 21st century Army; and incrementally fielding Capability Packages that best meet the needs of Soldiers and units as they train and then deploy. Army Network.—Central to the Army’s modernization efforts is an enhanced and interoperable communication network that gives the Army a decisive advantage across the spectrum of conflict. The network supports leaders in making timely, informed decisions, and supports organizational agility, lethality, and sustainability. It allows our Soldiers to know where the enemy is, where other friendly forces and civilian populations are, and what weapon systems are available for them at any given time. The network links Soldiers on the battlefield with space-based and aerial sensors, robots, and command posts—providing unprecedented situational awareness and control and enabling the application of precise lethal fires on the modern battlefield. Maintaining our technological advantage is a constant challenge. The Army’s battle command network must be continuously upgraded to ensure security and provide improved capability, capacity, connectivity and operational effectiveness. The Warfighter Information Network (Tactical) (WIN–T) is designed to extend the network ultimately to the company level for BCTs and provide real-time information, such as high definition imagery, from surveillance sources. The Joint Tactical Radio System (JTRS) was born Joint with the specific requirement to resolve radio interoperability among the services. It will provide Soldiers at the tactical level with connectivity at extended ranges, including voice, data, and video, enabling them to move information from platoon to higher-level command posts in complex terrain (including urban and mountainous areas). MRAP Strategy.—In response to deadly IEDs in Iraq and Afghanistan, the Nation made a tremendous investment in fielding MRAPs that have saved lives by providing significantly improved protection for our Soldiers. The Army is incorporating these vehicles throughout its unit formations. Additionally, we used the basic design of the MRAP as the foundation for the M–ATV, modifying it for the mountainous terrain in Afghanistan and in other regions around the world. The MRAP family of vehicles provides the versatility our forces need to rapidly move around the battlefield, particularly in an IED environment, with the best protection we can provide. Ground Combat Vehicle.—Combining the lessons learned from the survivability of the MRAP, the tactical mobility of the Bradley Fighting Vehicle, and the operational mobility of the Stryker, the Army is developing a Ground Combat Vehicle (GCV) that possesses all of these qualities. Providing Soldiers protected mobility is our top design criteria. The first combat vehicle designed from the ground up to operate in an IED environment, the GCV will have enhanced mobility that will allow it to operate effectively in both urban and off-road environments. It will be designed to host the Army’s network. And perhaps most importantly, it will have the capacity avail- 13 able to accept future upgrades incrementally as technologies mature and threats change. The GCV will be versatile enough to support our expeditionary requirements and be capable of carrying an infantry squad. It will combine sustainability features that match the availability rates of the Stryker while consuming less fuel than current vehicles of similar weight and power. The pace of change and the operational environment demand an expedited acquisition timeline, so the Army is pursuing a GCV program timeline that provides the first production vehicles in seven years. Capability Packages.—Capability packages provide the Army a regular, timely process to enable our deployable units with the latest materiel and non-materiel solutions based on the evolving challenges of the operating environment. The best available capabilities will go to the Soldiers who need them most, based on the threats they are likely to face. These bundles of capabilities will include materiel, doctrine, organization, and training to fill the highest priority requirements and mitigate risk for Soldiers. This incremental packaging approach will enable leaders to make timely, resource-informed decisions, and will help ensure that we provide the best available technologies to fulfill urgent needs to Soldiers in the fight—all driven by the cyclic readiness produced by ARFORGEN. These capability packages will upgrade our units as they prepare to deploy by providing them improved capabilities such as precision fires and advanced Intelligence, Surveillance and Recon- naissance (ISR). The Army Modernization Strategy The Army’s Brigade Combat Team Modernization Plan is a key element of our overall Army Modernization Strategy. The Army Modernization Strategy reflects our overarching vision of how we will achieve our ends, which is to: —Develop and field an affordable and interoperable mix of the best equipment available to allow Soldiers and units to succeed in both today’s and tomorrow’s full spectrum military operations. The Army Modernization Strategy relies on three interrelated lines of effort: —Develop and field new capabilities to meet identified capability ‘‘gaps’’ through traditional or rapid acquisition processes. In support of this Line of Effort in fiscal year 2011 we have requested $934 million to develop the Army’s new Ground Combat Vehicle (GCV), which will overcome critical capability gaps in both current and future operations. It is envisioned to have the tactical mobility of a Bradley, the operational mobility of a Stryker, and the protection of an MRAP. We are also requesting $459 million to procure the Extended Range Multi-Purpose Unmanned Aerial Vehicle. This extraordinarily capable platform, which is already making a difference in Operation Enduring Freedom, gives commanders longer dwell ISR capabilities across a joint area of operations. —Continuously modernize equipment to meet current and future capability needs through upgrade, replacement, recapitalization, refurbishment, and technology insertions. Army efforts in this Line of Effort include our request for $887 million for the procurement of 16 Block III AH–64 Apache Helicopters, as well as the upgrade of 13 AH–64 Helicopters to Block II. Block III Apache is part of a long-term effort to improve situational awareness, performance, reliability, and sustainment of the Apache. Block II upgrades continue our commitment to modernize the Army National Guard Aviation Fleet. Additionally, in this line of effort, we have requested $505 million to upgrade Shadow RQ–7 UAVs. This key upgrade will increase the payload capacity and enhance the performance of this key ISR asset for our BCT Commanders. —Meet continuously evolving force requirements in the current operational environment by fielding and distributing capabilities in accordance with the Army Resource Priorities List (ARPL) and Army Force Generation (ARFORGEN) Model. Meeting the constantly evolving needs of theater commanders and the demands of persistent conflict will require unprecedented agility in our equipping and modernization programs. One example of this agility can be found in our Kiowa Warrior fleet. We are currently maneuvering our fleet of OH–58D Kiowa Warrior Light Helicopters to meet Army and COCOM requirements based on the ARFORGEN model. As Air Cavalry Squadrons return from conflict, their OH–58D helicopters are placed into Reset. Units in Reset have very few aircraft, if any. Because the Kiowa Warrior fleet is short 35 aircraft overall, when the squadrons transition into the Train/Ready Phase of ARFORGEN, they are provided a number of helicopters sufficient to conduct training (25), but less than what they are fully authorized (30). When the units move into the Avail- able phase, they are provided their full complement of aircraft. It is this agility that has allowed Army forces to meet the needs of theater commanders for over eight years of sustained combat. 14

What do we need? Congress has been very supportive of Army Modernization needs in the past. Their tremendous support has ensured that the Army Soldier is the best equipped and most respected combatant in the world. In order to execute Army Modernization and ensure the continued success of Soldiers and units, we depend on a variety of resources, not the least of which is predictable funding. For fiscal year 2011, we have requested $31.7 billion for procurement and Research, De- velopment, Test and Evaluation (RDT&E) efforts. Adapting the Institution and Transforming Business Practices In addition to modernizing our operating force, we are transforming our institutional Army. As required by Section 904 of the 2008 National Defense Authorization Act (NDAA), the appointment of the Under Secretary of the Army as the Army’s Chief Management Officer (CMO) has allowed the Army to develop a series of initiatives to adapt the institutional Army and transform our business practices. In accordance with Section 908 of the 2009 NDAA, these efforts will result in the development and implementation of a comprehensive program that establishes a series of measurable performance goals and objectives. Specifically, the comprehensive program will address the following: —Developing and implementing a business transformation plan focused on running the Army as effectively and efficiently as possible. —Continuing the Army’s business process reengineering activities, led by OSD’s Business Transformation Agency. —Developing an integrated business systems architecture that emphasizes transparency and seamless access to data, and provides timely and accurate information to decision makers. —Preparing Army leaders to take a greater role in inculcating the Army with a cost-conscious culture. While the Army transformed its operating force—building versatile, agile units capable of adapting to changing environments—the institutional Army continued to use processes and procedures that were designed to support a pre-9/11 Army based on tiered levels of readiness. To support this new operating force, the Army must have an updated institutional Army—our generating force. Once the mission is defined, our institutions must seamlessly and continuously adapt—tailoring force packages and quickly adjusting training, manning, and equipping—to ensure units have all of the physical and mental tools necessary to succeed. Institutional agility allows us to adapt to the realities that present themselves. To that end, the CMO and Office of Business Transformation will build upon progress that has already been made toward the Army’s institutional adaptation, specifically: —Improvement of the ARFORGEN process—aligning the generating force and its processes to better support Soldiers, Families, and units within the operating force. —Adoption of an Enterprise Approach—developing civilian and military leaders who take a collaborative, holistic view of Army objectives and resources to make better decisions for the Army. —Reformation of the requirements and resource processes—delivering timely and necessary capabilities at best value. This transformational approach will overlay everything that the institutional Army does, with the unwavering goal of effectively and efficiently providing trained and ready forces to meet combatant commander requirements.

STEWARDSHIP AND INNOVATION The Army remains devoted to the best possible stewardship of the resources it is provided by the American people through Congress. The establishment of the CMO and initiatives related to the transformation of Army business practices represent the Army’s effort to act as a responsible steward. Several other initiatives serve to conserve resources and to reduce waste and inefficiencies wherever possible. The Army achieved full operating capability of the new Army Contracting Com- mand, Expeditionary Contracting Command, and Mission and Installation Con- tracting Command in 2009. These organizations are dedicated to ensuring professional, ethical, efficient, and responsive contracting. Civilians are assuming increased responsibilities within the Army. The Army is recouping intellectual capital by in-sourcing former contracted positions that were associated with inherently governmental functions. In fiscal year 2009, the Army saved significant resources by in-sourcing more than 900 core governmental functions to Army Civilians. We plan to in-source 7,162 positions in fiscal year 2010, and are programmed to in-source 11,084 positions during fiscal year 2011–2015, of 15 which 3,988 are acquisition positions. These positions were identified in the Army’s ongoing contractor inventory review process. In the Employer Partnership program, the Army Reserve works with public agencies and private employers to leverage their shared interests in recruiting, training, and credentialing highly skilled Citizen-Soldiers. The Army Reserve has signed more than 800 partnership agreements with corporations, state agencies, and local police departments. Energy security is a key component of Army installations, weapons systems, and operations. The Army has developed a comprehensive energy security strategy, and is acting now to implement initiatives to make us less dependent on foreign sources of fuel and better stewards of our nation’s energy resources. In support of these goals, we fielded the largest hybrid vehicle fleet within the Department of Defense. Energy will continue to be a key consideration in all Army activities in order to reduce demand, increase efficiency, seek alternative sources, and create a culture of energy accountability, while sustaining or enhancing operational capabilities. The Army is committed to environmental stewardship. Through cooperative partner agreements and the Army Compatible Use Buffer Program, the Army protected more than 28,000 acres of land at 14 locations in fiscal year 2009. Through creative solutions, the Army continues to conduct realistic training on its installations while protecting threatened and endangered species on Army lands.

AMERICA’S ARMY—THE STRENGTH OF THE NATION The professionalism, dedicated service, and sacrifice of our all-volunteer force are hallmarks of the Army—the Strength of our Nation. Our Soldiers and their Families quietly bear the burdens of a Nation at war. Our Civilians stand with them, dedicated to the Nation and the Army that serves it. De- spite the toll that 8 years of combat has taken, these great Americans continue to step forward to answer our Nation’s call. In an environment in which we must make hard choices, they deserve the very best we can offer, commensurate with their dedication and sacrifice. To continue to fulfill our vital role for the Nation, the Army must sustain its efforts to restore balance and set conditions for the future. We have made significant progress this year, but challenges remain. The continued support of Congress will ensure that the Army remains manned, trained, and equipped to protect our national security interests at home and abroad, now and in the future. America’s Army—the Strength of the Nation.

ADDENDUM A—THE FISCAL YEAR 2011 PRESIDENT’S BUDGET The fiscal year 2011 President’s budget asks for $245.6 billion for the Army. This budget, which includes $143.4 billion for the Base and $102.2 billion for the Over- seas Contingency Operations (OCO) request, is necessary to: support current operations, increase forces in Afghanistan, responsibly drawdown in Iraq, sustain the all-volunteer force, and prepare for future threats. 16

Amounts requested by major appropriation category in the fiscal year 2011 Presi- dent’s budget include: Military Personnel The fiscal year 2011 budget requests $71.0 billion, a $300 million increase over fiscal year 2010. Military Personnel funds support Army end-strength requirements for a Nation at war. This includes $1.2 billion for the temporary wartime increase in personnel, an increase of $684 million over fiscal year 2010. This amount funds pay, benefits, and associated personnel costs for 1,110,600 Sol- diers: 547,400 Active, 358,200 Army National Guard, 205,000 Army Reserve and funds an active component temporary end strength increase of 22,000. The OCO request will fund special pays, incentives, and the mobilization of reserve component Soldiers. 17

Compelling Needs Support the Army’s base endstrength and the temporary end strength increase in fiscal year 2011 to reduce strain on the force. Sustain authorities and funding of programs in support of wounded, ill, and injured Warriors and their Families as they transition back to duty or to civilian life. Provide recruiting and retention incentives and benefits to sustain the quality of our all-volunteer force, allow the Army to meet end-strength objectives, and achieve Army standards for recruit quality. Enable the transition of the reserve component to an operational force by systematically building and sustaining readiness across the force and fund mobilization of RC units to support growing demand. Operation and Maintenance The fiscal year 2011 budget requests $107.3 billion—a $7 billion increase from fiscal year 2010. Operation and maintenance funds Soldier and unit training; ground and air vehicle operating costs; depot maintenance; base operations, sustainment, restoration, and modernization; and a 1.4 percent Civilian pay raise. The OCO portion of the request includes $628 million for the training and sustainment of the temporary wartime increase in personnel—an increase of $242 million from fiscal year 2010. The budget request works to restore balance to the force by recognizing $587 million of enduring requirements for training and depot maintenance in the base rather than in OCO. The base funds home station training for 59 brigade combat teams, 24 rotations through the Army’s combined arms training centers, and an increased investment of $154 million in scholarships, language and individual training. It improves network security; operationalizes the LandWarNet; supports continued development and fielding of administrative systems; and provides funding for improvements in financial audit readiness (as required in NDAA 2009) by requesting an additional $578 million above the fiscal year 2010 levels for these activities. The base budget also increases funding for facilities sustainment restoration and modernization by $320 million and includes one-time requests to support BRAC and the transition out of NSPS. The OCO request will fund the day-to-day cost of the wars, training to prepare units for deployment, force protection, in-theater maintenance and repair, drawdown of equipment from Iraq, and reset of Army Prepositioned Stocks and equipment returning from deployment. Compelling Needs Sustain readiness through Soldier and unit training, including realistic, full spectrum training at the Army’s three combat training centers. Fund the reset of 30 brigades, other enabling units, and equipment. Resource installation services worldwide and support the Army Family Covenant to provide Soldiers and their Families the quality of life they deserve and to enhance the health of the force. Procurement The fiscal year 2011 budget requests $30.3 billion—a $200 million decrease from fiscal year 2010. Procurement funds the Army’s future force equipment requirements; sustains modernization and recapitalization; and fills equipment shortages. The OCO request will fund procurement of weapon systems to replace battle losses, replacement of equipment taken for current operations from the reserve components, and to fill urgent operational needs for deployed forces. Compelling Needs Fund the fielding of the first Capability Packages to two more Army brigades. Enhance Army command and control by providing an initial on-the-move networking capability resident in the Warfighter Information Network—Tactical (WIN– T), Increment 2. Increase the Army’s tactical agility through an aviation modernization strategy that highlights the increasing importance of unmanned aerial systems (ERMP, Shadow and Raven) and rotary wing aviation (AH–64D Block III Apache, UH–60M Black Hawk and CH–47F Chinook). Improve lethality and precision fires by modernizing the Patriot PAC–3 missile, the Guided Multiple Launch Rocket System, the High Mobility Artillery Rocket Sys- tem, and the Paladin howitzer. Sustain access to training and war reserve ammunition by restoring stocks and the selective repair, upgrade and replacement of key ammunition production base equipment and facilities. 18

Research, Development, Test and Evaluation The fiscal year 2011 budget requests $10.5 billion, approximately the same amount requested last year. Compelling Needs Fund Brigade Combat Team modernization including initial Ground Combat Vehi- cle development and further development of the second set of Capability Packages. Support Network modernization including continued development of WIN–T increment 2 and increment 3. Continues the international partnership to develop the Patriot Medium Extended Air Defense systems (MEADS) Construction, Base Realignment and Closure (BRAC), and Army Housing Fiscal year 2011 is a critical year for BRAC since this will be the final budget executed to meet the statutory deadline for many of the BRAC actions. fiscal year 2011 will be a particularly challenging year for BRAC as four of our major command headquarters and many of our military schools will be moving to new locations. The fiscal year 2011 budget requests $7.9 billion—a $2.5 billion decrease from fiscal year 2010. This funding supports the construction of facilities to support the growth and re-stationing of Army forces. The OCO request will fund construction in Afghani- stan. Compelling Needs Fund BRAC requirements to meet fiscal year 2011 statutory timelines. Support construction of new family housing and improvements to existing housing. Support construction of permanent party and training barracks. Other Accounts The Army is the executive agent for a variety of critical functions within the De- partment of Defense, to include the Chemical Agents and Munitions Destruction Program. Funding for this account is $1.6 billion in fiscal year 2011—a decrease of $100 million from fiscal year 2010. The Army also has responsibility for the Iraq Security Forces Fund (ISFF), Afghanistan Security Forces Fund (ASFF), and Joint Improvised Explosive Device Defeat Organization (JIEDDO) appropriations. The Army budgets for recurring sustainment costs of JIEDDO with fiscal year 2011 funds at $200 million—an increase of $100 million from fiscal year 2010. The OCO Request will fund JIEDDO initiatives. The ISFF and ASFF are funded entirely through the OCO request. Compelling Needs Fund the Afghan Security Forces Fund and the Iraq Security Forces Fund to enable building essential security capacity. Support JIEDDO appropriations and initiatives to combat the most dangerous threat to U.S. forces. Continue the safe destruction of chemical agents and munitions and the closure activities at selected chemical demilitarization sites. Restoring Fiscal Balance Timely and full funding of the Army’s fiscal year 2011 request of $245.6 billion will help ensure the Army is ready to meet the needs of the Nation and continue the process of restoring balance while setting the conditions for the future. Over the last 8 years, the Army has received significant portions of its funding for combat readiness through OCO appropriations. This recurring reliance on OCO funds and an overlap between base and OCO sustainment programs means that the Army’s base budget does not fully cover the cost of both current and future readiness requirements. Because of this reliance, a precipitous drop or delay in OCO funding does not fully fund the readiness of our Army for the current conflict. Army continues the orderly restoration of the balance between base and OCO requirements in its fiscal year 2011 base budget request. This request fully funds Army authorized end strength and brings $965 million in O&M expenses back into the base rather than finance those requirements in OCO.

ADDENDUM B—RESERVE COMPONENT READINESS Sections 517 and 521 of the National Defense Authorization Act (NDAA) 1994 require the information in this addendum be reported. Section 517 requires a report relating to implementation of the pilot Program for Active Component Support of the Reserves under Section 414 of the NDAA 1992 and 1993. Section 521 requires a detailed presentation concerning the Army National Guard (ARNG), including in- 19 formation relating to implementation of the ARNG Combat Readiness Reform Act of 1992 (Title XI of Public Law 102–484, referred to in this addendum as ANGCRRA). Section 521 reporting was later amended by Section 704 of NDAA 1996. U.S. Army Reserve information is also presented using Section 521 report criteria. Section 517(b)(2)(A).—The promotion rate for officers considered for promotion from within the promotion zone who are serving as active component advisors to units of the Selected Reserve of the Ready Reserve (in accordance with that program) compared with the promotion rate for other officers considered for promotion from within the promotion zone in the same pay grade and the same competitive category, shown for all officers of the Army.

Fiscal year 2008 Fiscal year 2009 In the Zone Army Aver- Army Aver- AC in RC 1 Percent age (per- Percent AC in RC 1 age (percent) 2 cent) 2

Major ...... 0 of 1 ...... 92.8 56 of 63 88.9 94.1 Lieutenant Colonel ...... 1 of 1 100 89.1 16 of 20 80.0 87.9 1 Active component officers serving in reserve component assignments at time of consideration. 2 Active component officers not serving in reserve component assignments at the time of consideration. Section 517(b)(2)(B).—The promotion rate for officers considered for promotion from below the promotion zone who are serving as active component advisors to units of the Selected Reserve of the Ready Reserve (in accordance with that program) compared in the same manner as specified in subparagraph (A) (the paragraph above).

Fiscal year 2008 Fiscal year 2009 Below the Zone Army Aver- Army Aver- AC in RC 1 Percent age (per- Percent AC in RC 1 age (percent) 2 cent) 2

Major ...... 0 of 4 ...... 4.9 2 of 4 50.0 6.0 Lieutenant Colonel ...... 0 of 0 ...... 13.5 0 of 1 ...... 7.2 1 Below the zone active component officers serving in reserve component assignments at time of consideration. 2 Below-the-zone active component officers not serving in reserve component assignments at time of consideration. Section 521(b) 1. The number and percentage of officers with at least 2 years of active-duty before becoming a member of the Army National Guard or the U.S. Army Reserve Se- lected Reserve units. ARNG officers: 14,760 or 36.3 percent Army Reserve officers: 19,573 or 59 percent 2. The number and percentage of enlisted personnel with at least 2 years of active-duty before becoming a member of the Army National Guard or the U.S. Army Reserve Selected Reserve units. ARNG enlisted: 85,255 or 26.8 percent Army Reserve enlisted: 63,311 or 41.6 percent 3. The number of officers who are graduates of one of the service academies and were released from active duty before the completion of their active-duty service obligation and, of those officers: —The number who are serving the remaining period of their active-duty service obligation as a member of the Selected Reserve pursuant to section 1112(a)(1) of ANGCRRA: —In fiscal year 2009, 10 graduates from Service Academies were serving in the Army National Guard to complete their service obligation. —In fiscal year 2009, 0 graduates from Service Academies were serving in the Army Reserve to complete their service obligation. —The number for whom waivers were granted by the Secretary of the Army under section 1112(a)(2) of ANGCRRA, together with the reason for each waiver: —In fiscal year 2009, no waivers were granted by the Secretary of the Army. 4. The number of officers who were commissioned as distinguished Reserve Offi- cers’ Training Corps graduates and were released from active duty before the completion of their active-duty service obligation and, of those officers: —The number who are serving the remaining period of their active-duty service obligation as a member of the Selected Reserve pursuant to section 1112(a)(1) of ANGCRRA: 20

—In fiscal year 2009, no distinguished Reserve Officers’ Training Corps (ROTC) graduate was released before completing their active-duty service obligation. —The number for whom waivers were granted by the Secretary of the Army under section 1112(a)(2) of ANGCRRA, together with the reason for each waiver: —In fiscal year 2009, no waivers were granted by the Secretary of the Army. 5. The number of officers who are graduates of the Reserve Officers’ Training Corps program and who are performing their minimum period of obligated service in accordance with section 1112(b) of ANGCRRA by a combination of (a) 2 years of active duty, and (b) such additional period of service as is necessary to complete the remainder of such obligation served in the National Guard and, of those officers, the number for whom permission to perform their minimum period of obligated service in accordance with that section was granted during the preceding fiscal year: —In fiscal year 2009, one ROTC graduate was released early from their active- duty obligation. The officer is serving the remainder of his/her obligation in the ARNG 6. The number of officers for whom recommendations were made during the preceding fiscal year for a unit vacancy promotion to a grade above first lieutenant, and of those recommendations, the number and percentage that were concurred in by an active duty officer under section 1113(a) of ANGCRRA, shown separately for each of the three categories of officers set forth in section 1113(b) of ANGCRRA (with Army Reserve data also reported). —There are no longer active and reserve component associations due to operational mission requirements and deployment tempo. Active component officers no longer concur or non-concur with unit vacancy promotion recommendations for officers in associated units according to section 1113(a). However, unit vacancy promotion boards have active component representation. —In fiscal year 2009, 2,223 ARNG officers from units were recommended for position-vacancy promotion and promoted. This number consists of 319 U.S. Army Medical Department, 1,864 Army Promotion List and 40 Chaplains. —In fiscal year 2009 the estimated percentage of Unit Vacancy Promotions CPT through COL in which an active component representation was on the state unit vacancy promotion board is as follows:

Percent

AMEDD ...... 12 APL ...... 10 Chaplain ...... 13

—In fiscal year 2009, 59 Army Reserve officers from units were recommended for position-vacancy promotion and promoted. This number consists of 9 U.S. Army Medical Department, 47 Army Promotion List, and 3 Chaplains. 7. The number of waivers during the preceding fiscal year under section 1114(a) of ANGCRRA of any standard prescribed by the Secretary establishing a military education requirement for non-commissioned officers and the reason for each such waiver. —In fiscal year 2009, the ARNG had a total of 201 Noncommissioned Officers receive a military education waiver. As of September 30, 2009 all those waiver recipients were eligible for promotion to the next rank, but none have obtained the military education requirement that was previously waived. —In fiscal year 2009, the Army Reserve had a total of 331 Soldiers receive a military education waiver. Of these, 124 were SGTs in need of a waiver for Warrior Leader Course (WLC) as a result of being deployed or assigned to Warrior Tran- sition Units (WTU) (Medical Hold or Medical Hold-Over Units) whose medical condition was incurred in direct support of Overseas Contingency Operations and who were otherwise eligible for promotion, if recommended. Furthermore, eligible Soldiers lacking the prerequisite level of military education due to operational deployment conflicts or the inability of the Army to schedule the course, were granted waivers. This included 173 Soldiers who were granted waivers for the Basic NCO Course (Now Advanced Leader Course) and 34 Soldiers who were granted waivers for the Advanced NCO Course (now Senior Leader Course). —The Secretary of the Army has delegated the authority for the waivers referred to in section 1114(a) of ANGCRRA to the Director, ARNG and to the Com- mander, U.S. Army Reserve Command. A majority of these waivers were approved due to the Soldiers being deployed and/or performing operational missions. Each reserve component maintains details for each waiver. 21

8. The number and distribution by grade, shown for each State, of personnel in the initial entry training and non-deployability personnel accounting category established under section 1115 of ANGCRRA for members of the Army National Guard who have not completed the minimum training required for deployment or who are otherwise not available for deployment. (A narrative summary of information pertaining to the Army Reserve is also provided.) —In fiscal year 2009, the ARNG had 61,812 Soldiers considered non-deployable for reasons outlined in Army Regulation 220–1, Unit Status Reporting (e.g., pending administrative/legal discharge or separation, medical non-availability, incomplete initial entry training, officer transition, unsatisfactory participation, or restrictions on the use or possession of weapons and ammunition under the Lautenberg Amendment). —In fiscal year 2009, the Army Reserve had 49,330 Soldiers considered non- deployable for reasons outlined in Army Regulation 220–1, Unit Status Report- ing (e.g., pending administrative/legal discharge or separation, medical non- availability, incomplete initial entry training, officer transition, unsatisfactory participation, or restrictions on the use or possession of weapons and ammunition under the Lautenberg Amendment). 9. The number of members of the Army National Guard, shown for each State, that were discharged during the previous fiscal year pursuant to section 1115(c)(1) of ANGCRRA for not completing the minimum training required for deployment within 24 months after entering the National Guard. (Army Reserve data also reported.) —The number of ARNG Soldiers discharged during fiscal year 2009 pursuant to section 1115(c)(1) of ANGCRRA for not completing the minimum training required for deployment within 24 months after entering the Army National Guard is 141 officers and 15,105 enlisted Soldiers from all U.S. states and territories. The breakdown by each state is maintained by the NGB. —The number of Army Reserve Soldiers discharged during fiscal year 2009 for not completing the minimum training required for deployment within 24 months after entering the Army Reserve is 63 officers and 2,910 enlisted Soldiers. Sol- diers who have not completed the required initial entry training within the first 24 months are discharged from the Army Reserve under AR 135–178, Separa- tion of Enlisted Personnel. Officers who have not completed a basic branch course within 36 months after commissioning are separated under AR 135–175, Separation of Officers. 10. The number of waivers, shown for each State, that were granted by the Sec- retary of the Army during the previous fiscal year under section 1115(c)(2) of ANGCRRA of the requirement in section 1115(c)(1) of ANGCRRA described in paragraph (9), together with the reason for each waiver. —In fiscal year 2009, no waivers were granted by the Secretary of the Army for the Army National Guard or the U.S. Army Reserve. 11. The number of Army National Guard members, shown for each State, (and the number of AR members), who were screened during the preceding fiscal year to determine whether they meet minimum physical profile standards required for deployment and, of those members: (a) the number and percentage that did not meet minimum physical profile standards for deployment; and (b) the number and percentage who were transferred pursuant to section 1116 of ANGCRRA to the personnel accounting category described in paragraph (8). —The number and percentage who did not meet minimum physical profile standards required for deployment: —In fiscal year 2009, 242,777 ARNG Soldiers underwent a Periodic Health As- sessment (PHA) physical. Of these personnel 18,830 or 7.7 percent were identified for review due to a possible deployment limiting condition or failure to meet retention standards. —In fiscal year 2009, 115,133 Army Reserve Soldiers underwent a PHA physical. Of these personnel 21,505, or 18.68 percent were identified for review due to a possible deployment limiting condition or failure to meet retention standards. The fiscal year 2008–2009 increase is most attributable to PHA physicals now being required annually. —The number and percentage that were transferred pursuant to section 1116 of ANGCRRA to the personnel accounting category described in paragraph (8). —In fiscal year 2009, 18,830 ARNG Soldiers were transferred from deployable to nondeployable status for failing to meet medical deployability standards. This number includes Soldiers returning from a mobilization with a new medical condition and reflects an increase in the accuracy of electronic databases. —In fiscal year 2009, 21,505 Army Reserve Soldiers were considered non-available for deployment for failing to meet medical deployability standards. The 22

new PHA physicals being required annually may account for the increase in those being found to be non-deployable. 12. The number of members and the percentage total membership of the Army National Guard shown for each State who underwent a medical screening during the previous fiscal year as provided in section 1117 of ANGCRRA. —Repealed. Public Law 104–106 (NDAA 1996), Div. A, Title VII, Section 704(b), February 10, 1996, repealed Section 1117 of ANGCRRA. 13. The number of members and the percentage of the total membership of the Army National Guard shown for each State who underwent a dental screening during the previous fiscal year as provided in section 1117 of ANGCRRA. —Repealed. Public Law 104–106 (NDAA 1996), Div. A, Title VII, Section 704(b), February 10, 1996, repealed Section 1117 of ANGCRRA. 14. The number of members and the percentage of the total membership of the Army National Guard shown for each State, over the age of 40 who underwent a full physical examination during the previous fiscal year for purposes of section 1117 of ANGCRRA. —Repealed. Public Law 104–106 (NDAA 1996), Div. A, Title VII, Section 704(b), February 10, 1996, repealed Section 1117 of ANGCRRA. 15. The number of units of the Army National Guard that are scheduled for early deployment in the event of a mobilization, and of those units, the number that are dentally ready for deployment in accordance with section 1118 of ANGCRRA. —Repealed. Public Law 104–106 (NDAA 1996), Div. A, Title VII, Section 704(b), February 10, 1996, repealed Section 1118 of ANGCRRA. 16. The estimated post-mobilization training time for each Army National Guard combat unit (and Army Reserve unit), and a description, displayed in broad categories and by State of what training would need to be accomplished for Army Na- tional Guard combat units (and AR units) in a post-mobilization period for purposes of section 1119 of ANGCRRA. —Per January 2007 direction from the Secretary of Defense (SECDEF) reserve component unit mobilizations are limited to 400-day periods, including a 30-day post-mobilization leave and all post-mobilization training. —The most significant impact of this policy change is that many training tasks previously conducted during the first 3 to 6 months of mobilization have been identified for premobilization training, and units are training to standard on as many of these tasks as resources permit. Information on the type of training required by units during postmobilization is maintained by First Army. The data are not captured by state. —ARNG units strive to train in accordance with the Army Force Generation (ARFORGEN) process in order to prepare for operational missions and reduce post-mobilization training time. The ARFORGEN process requires increased resources for company-level training proficiency prior to mobilization. This training generally consists of individual warrior training tasks, weapons qualification and gunnery, battle staff training, and maneuver training. This is followed by theater-specific tasks and higher level collective training to complete the predeployment requirements for the unit’s specific mission. The goal for post- mobilization training time for a brigade-size organization is approximately 60 days. —Post-mobilization training time is contingent upon the amount of certified pre- mobilization training conducted, the type of unit, and its assigned mission. In order to reduce post-mobilization training time, the ARNG has developed programs and products such as the ARNG Battle Command Training Capability, the eXportable Combat Training Capability (XCTC), training devices, and range complexes for our units. —The combination of programs and products, provide units with the capability to accomplish more during pre-mobilization training and therefore reduce post-mobilization training time. —The Army Reserve developed the Regional Training Center (RTC) concept in response to the SECDEF decision to restrict RC mobilizations to 1 year. These centers provide the capability for Army Reserve units to conduct training on Theater Specific Required Training (TSRT) to theater standards and conditions. The majority of training is on individual tasks but some collective training is also conducted. Because of certification by unit commanders, most of the training is not repeated in post-mobilization status. Exceptions are for tasks incorporated into other required training events and for convoy operations training. —The TSRT training is for units that will deploy to theater, including non-rotational forces (MTOE and TDA). Units mobilizing for CONUS based missions do not require this training. 23

—Each RTC conducts standard rotations throughout the year although each has the capability to adjust training for selected large unit participation. Initially the Army Reserve provided a staff projection to DA that the training would require 17 days, but in actual implementation the training has required 21 days. —Army goals for post-mobilization training for Army Reserve headquarters and combat support/combat service support units range from 30 to 60 days. Post- mobilization training conducted by First Army typically consists of counterinsurgency operations, counter-improvised-explosive-device training, convoy live- fire exercises, theater orientation, rules of engagement/escalation-of-force training, and completion of any theater-specified training not completed during the pre-mobilization period. 17. A description of the measures taken during the preceding fiscal year to comply with the requirement in section 1120 of ANGCRRA to expand the use of simulations, simulators, and advanced training devices and technologies for members and units of the Army National Guard (and the Army Reserve). —During fiscal year 2009, the ARNG continued to synchronize the use of existing and ongoing live, virtual, and constructive training aids, devices, simulations and simulators (TADSS) programs with the training requirements of the ARFORGEN training model. By synchronizing the use of TADSS with ARFORGEN, the ARNG continues to improve unit training proficiency prior to mobilization. —To support the training requirements of M1A1 Abrams and M2A2 Bradley- equipped Brigade Combat Teams (BCT’s), the ARNG continued the fielding of the Advanced Bradley Full-Crew Interactive Simulation Trainer, which provides full crew-simulations training for M2A2 units, Tabletop Full-fidelity Trainers for the M2A2, and the Conduct of Fire Trainer XXI for M1A1 and M2A2. When fully fielded, these devices, in addition to the Abrams Full-Crew Interactive Simulation Trainer XXI, will be the primary simulations trainers to meet the virtual gunnery requirements of M1A1 and M2A2 crews. —In order to meet the virtual-maneuver training requirements in the ARFORGEN process, M1A1 and M2A2 units use the Close-Combat Tactical Trainer (CCTT) and the Rehosted Simulations Network (SIMNET) XXI, in addition to the Rehosted SIMNET CCTT Core. The CCTT, SIMNET XXI, and SIMNET CCTT provide a mobile training capability to our dispersed units. —In order to train all ARNG units on the tactics, techniques, and procedures (TTPs) of convoy operations, the ARNG is fielding the Virtual Convoy Oper- ations Trainer (VCOT). The VCOT, through the use of geo-specific databases, provides commanders with a unique and critical mission rehearsal tool. Cur- rently, 32 VCOT systems are positioned in the ARNG force to train units on the fundamentals of convoy operations. —In order to meet basic and advanced rifle marksmanship requirements, the ARNG is fielding the Engagement Skills Trainer (EST 2000). This system is the Army’s approved marksmanship-training device. The ARNG is also continuing use of its previously procured Fire Arms Training System (FATS) until EST 2000 fielding is complete. The EST 2000 and FATS are also used to provide unit collective tactical training for dismounted Infantry, Special Operations Forces, Scouts, Engineer, and Military Police squads, as well as combat support and combat service support elements. These systems also support units conducting vital homeland defense missions. —The ARNG supplements its marksmanship-training strategy with the Laser Marksmanship Training System (LMTS). The ARNG currently has over 900 systems fielded down to the company level. The LMTS is a laser-based training device that replicates the firing of the Soldier’s weapon without live ammunition. It is utilized for developing and sustaining marksmanship skills, diagnosing and correcting marksmanship problems, and assessing basic and advanced skills. —The ARNG has further developed its battle command training capability through the three designated Battle Command Training Centers (BCTCs) at Fort Leavenworth, Camp Dodge, and Fort Indiantown Gap, and the Distributed Battle Simulation Program (DBSP). BCTCs provide the backbone of the program as collective hubs in the battle command training strategy. The DBSP provides Commanders assistance from Commander’s Operational Training As- sistants, TADSS facilitators, and Technical Support Teams. BCTCs and the DBSP collectively help units in the planning, preparation, and execution of simulations-based battle staff training that augments the Department of the Army- directed Warfighter Exercises and greatly enhances battle staff and unit proficiency. 24

—In order to provide the critical culminating training event of ARFORGEN, the ARNG has implemented the XCTC. The XCTC program provides the method to certify that ARNG combat units have achieved company-level maneuver proficiency prior to mobilization. The XCTC incorporates the use of advanced live, virtual, and constructive training technologies to replicate the training experience until now only found at one of the Army’s Combat Training Centers. The centerpiece of the XCTC is the Deployable Force-on-Force Instrumented Range System (DFIRST). DFIRST utilizes training technologies that allow for full instrumentation of the training area from major combat systems down to the individual Soldier, role player, and Civilian on the battlefield. —The most important part of every training exercise is the After-Action Review (AAR). By full instrumentation of the units, Soldiers, and training areas, units receive an AAR complete with two-dimensional, three-dimensional, and video playback of the actual training exercise. This allows Commanders and Soldiers to see what occurred during the training exercise from a different perspective, further enhancing the training experience. —The Army Reserve continues to leverage—to the extent resources permit— TADSS into its training program. Implementation of Army Campaign Plan De- cision Point 72 continues with establishment of the 75th Battle Command Training Division (BCTD) (Provisional). This division, with five battle command training brigades, employs legacy constructive simulations to provide battle command and staff training to Army Reserve and Army National Guard battalion and brigade commanders and staffs during pre-mobilization and post-mobilization. The concept plan as well as requirements for supporting Army battle command systems and simulations drivers for the 75th BCTD is pending Head- quarters Department of the Army (HQDA) approval. —The Army Reserve continues to partner with the Program Executive Office, Simulations, Training and Instrumentation; Training and Doctrine Command agencies; and HQDA to define TADSS requirements for combat support and combat service support units. The 75th BCTD is on the Entity-level Resolution Federation (ERF) fielding plan. The ERF provides a high-resolution (e.g., individual Soldier-level fidelity aggregated to unit resolutions) joint constructive battle staff training simulation. —The LMTS and EST 2000 remain essential elements of Army Reserve marksmanship training. LMTS procurement continues, and distribution throughout the Army Reserve force continues to increase. The LMTS has also been adapted to support convoy operations training. In either individual pre-marksmanship training or convoy modes, the system allows the Soldier to use an assigned weapon, as well as crew-served weapons, in a simulation/training mode. EST 2000 systems have been fielded to many Army Reserve Engineer and Military Police organizations to enable full use of its training capabilities by units with high densities of crew-served weapons their at home stations. —The Army Reserve also has a number of low-density simulators it employs to reduce expensive ‘‘live’’ time for unique combat service support equipment. For example, Army Reserve watercraft units train on the Maritime Integrated Training System (MITS), a bridge simulator that not only trains vessel captains but the entire crew of Army watercraft. In 2007 the Army Reserve invested in communications infrastructure so that the MITS at Mare Island, California can communicate and interact with another Army MITS at Fort Eustis, Virginia. This provides the capability to conduct distributed multi-boat collective training among all the simulators. Of note, the MITS is also used by U.S. Navy, U.S. Coast Guard, and harbor management agencies. Other simulators include loco- motive simulators used by Army Reserve railroad units and a barge derrick simulator for floating watercraft maintenance units. Other simulator requirements are being identified in requirements documents. 18. Summary tables of unit readiness, shown for each State, (and for the Army Reserve), and drawn from the unit readiness rating system as required by section 1121 of ANGCRRA, including the personnel readiness rating information and the equipment readiness assessment information required by that section, together with: —Explanations of the information: Readiness tables are classified. This information is maintained by the Department of the Army, G–3. —Based on the information shown in the tables, the Secretary’s overall assessment of the deployability of units of the ARNG (and Army Reserve), including a discussion of personnel deficiencies and equipment shortfalls in accordance with section 1121: —Summary tables and overall assessments are classified. This information is maintained by the Department of the Army, G–3. 25

19. Summary tables, shown for each State (and Army Reserve), of the results of inspections of units of the Army National Guard (and Army Reserve) by inspectors general or other commissioned officers of the Regular Army under the provisions of Section 105 of Title 32, together with explanations of the information shown in the tables, and including display of: —The number of such inspections; —Identification of the entity conducting each inspection; —The number of units inspected; and —The overall results of such inspections, including the inspector’s determination for each inspected unit of whether the unit met deployability standards and, for those units not meeting deployability standards, the reasons for such failure and the status of corrective actions. —During fiscal year 2009, Inspectors General and other commissioned officers of the Regular Army conducted 947 inspections of the ARNG, inspecting 1,403 ARNG units. The bulk of these inspections, 711, were executed by Regular Army officers assigned to the respective States and Territories as Inspectors General. First Army and the Department of the Army Inspectors General conducted 96 of the inspections, and the remaining 140 by the U.S. Army Forces Command (FORSCOM); Training and Doctrine Command (TRADOC); Com- munications-Electronics Command (CECOM); and the U.S. Army Audit Agen- cy. Because the inspections conducted by Inspectors General focused on findings and recommendations, the units involved in these inspections were not provided with a pass/fail rating. Results of such inspections may be requested for release through The Inspector General of the Army. —Operational Readiness Evaluation data for the Force Support Package and expanded separate brigades are unavailable, as inspections thereof were eliminated as requirements in 1997. Data available under the Training Assess- ment Model (TAM) relates to readiness levels and is generally not available in an unclassified format. TAM data are maintained at the state level and are available upon request from state level-training readiness officials. —In accordance with AR 1–201, Army Inspection Policy, the U.S. Army Reserve Command (USARC) conducts inspections of regional readiness commands and direct support units within requirements of the USARC Organizational In- spection Program (OIP). Per the Army Regulation, OIPs at division levels and above mainly comprise staff inspections, staff assistance visits, and Inspectors General. Staff inspections are only one aspect by which Commanding Gen- erals can evaluate the readiness of their commands. The Inspector General conducts inspections and special assessments based on systemic issues and trends analysis with emphasis on issues that could impede the readiness of the Army Reserve. —The Chief, Army Reserve, directed the Inspector General to conduct special assessments in fiscal year 2009 prompted by concerns over systemic issues. One was the Special Assessment of Training Management. Its objective was to determine if units in the Army Reserve were in compliance with Command Training Guidance for Training Years 2008–2010, with emphasis on the execution of weapons training, remedial training, qualification, and ammunition availability. This assessment also encompassed an annual regulatory review of compliance with and effectiveness of the Army Voting Assistance Program, a program of special interest to the Department of the Army. Another was the Special Assessment of the Impact of Army Reserve Equipment Shortages (Funding/Availability/Modernization) and Training with the U.S. Army Re- serve Command (USARC), which evaluated training issues due to equipment shortages and the affect it had on our Soldiers’ morale. —The Army Reserve is meeting regulatory requirements through a combination of Battle-Focused Readiness Reviews (BFRRs) and staff assistance visits, with the assistance visits conforming to regulatory requirements of AR 1–201. The BFRR is the tool used by major subordinate Commanders to provide the Army Reserve Commanding General a status on resources and readiness of their commands, and resolve systemic issues/trends in order to achieve continuous improvements in readiness. The Army Reserve conducted 19 BFRRs in fiscal year 2009, while inspecting 65 units. The staff assistance visits were more oriented to a particular topic in the staff proponent’s area. 20. A listing, for each ARNG combat unit (and U.S. Army Reserve FSP units) of the active-duty combat units (and other units) associated with that ARNG (and U.S. Army Reserve) unit in accordance with section 1131(a) of ANGCRRA, shown by State, for each such ARNG unit (and for the U.S. Army Reserve) by: (A) the assessment of the commander of that associated active-duty unit of the manpower, equipment, and training resource requirements of that National Guard (and Army Re- 26 serve) unit in accordance with section 1131(b)(3) of the ANGCRRA; and (B) the results of the validation by the commander of that associated active-duty unit of the compatibility of that National Guard (or U.S. Army Reserve) unit with active duty forces in accordance with section 1131(b)(4) of ANGCRRA. —There are no longer ground combat active or reserve component associations due to operational mission requirements and deployment tempo. —As FORSCOM’s executive agent, First Army and U.S. Army Pacific (USARPAC) for Pacific based Reserve Component units, execute active duty associate unit responsibilities through both their pre-mobilization and post-mobilization efforts with reserve component units. When reserve component units are mobilized, they are thoroughly assessed in terms of manpower, equipment, and training by the appropriate chain of command, and that assessment is approved by First Army or USARPAC as part of the validation for unit deployment. —Validation of the compatibility of the Reserve Component units with the active duty forces occurs primarily during training and readiness activities at mobilization stations, with direct oversight by First Army, USARPAC, and FORSCOM. 21. A specification of the active-duty personnel assigned to units of the Selected Reserve pursuant to section 414(c) of the National Defense Authorization Act for Fiscal Years 1992 and 1993 (10 U.S.C. 261 note), shown (a) by State for the Army National Guard (and for the U.S. Army Reserve), (b) by rank of officers, warrant officers, and enlisted members assigned, and (c) by unit or other organizational entity of assignment. TITLE XI (FISCAL YEAR 2009) AUTHORIZATIONS

OFF ENL WO TOTAL

U.S. Army Reserve ...... 97 110 8 215 TRADOC ...... 50 3 0 53 FORSCOM ...... 979 2,165 101 3,245 USARPAC ...... 30 49 1 80

TOTAL ...... 1,156 2,327 102 3,593

TITLE XI (FISCAL YEAR 2009) ASSIGNED

OFF ENL WO TOTAL

U.S. Army Reserve ...... 28 77 7 112 TRADOC ...... 5 5 0 10 FORSCOM ...... 659 2,119 85 2,863 USARPAC ...... 28 53 1 82

TOTAL ...... 720 2,254 93 3,067

—As of September 30, 2009, the Army had 3,067 active component Soldiers assigned to Title XI positions. In fiscal year 2006, the Army began reducing authorizations in accordance with the National Defense Authorization Act 2005 (NDAA 2005, Public Laws 108–767, Section 515). Army G–1 and U.S. Army Human Resources Command (HRC) carefully manage the authorizations and fill of Title XI positions. The data is captured at the command level. The actual duty location for each position is not captured down to the state level of detail. Chairman INOUYE. And, may I now call upon General Casey. SUMMARY STATEMENT OF GENERAL GEORGE W. CASEY General CASEY. Thank you, Mr. Chairman, Senators. I’ll give you my whole statement for the record, and just try to summarize here for you, because of time. What I’d like to do, Mr. Chairman, is give you a short update on where we are on restoring balance, and then talk briefly about three areas that are priorities for the Army and, I would hope, for this committee, and that’s sustaining our soldiers and families, reset, and our modernization efforts. 27 Now, if I might, just to give you a quick update on balance, I’ve been saying, since 2007, that we were out of balance, that we were so weighed down by our current commitments that we couldn’t do the things we knew we needed to do to sustain this force for the long haul, this All-Volunteer Force, and to prepare ourselves to do other things. And, with you, we have been working steadily at this since 2007. I will tell you, this budget, this 2011 budget, plus the drawdown in Iraq, gives us the resources and the time to complete the efforts that we began in 2007 to get ourselves back in balance. Let me just give you an update on some key parameters: First of all, growth. We completed the personnel growth that President Bush directed in January 2007, late last summer. And that is a huge boost for us. But, even as we completed that growth, it was clear that, for a number of reasons, we needed to continue to grow. And, as you mentioned in your opening statement, Mr. Chairman, the Secretary of Defense did authorize us to grow by another 22,000, and we can talk a little bit more about that in the questions and answers. The second element of balance is probably the most important, and that’s ‘‘dwell,’’ the amount of time the soldiers spend at home. We have intuitively known that it takes about 2 or 3 years to recover from a 12-month combat deployment, yet we have been returning soldiers to combat in about 12 months, because we’ve been too small. Well, we’ve now documented that with a scientific study that we finished last year that shows it takes 2 to 3 years to recover from a 12-month combat deployment. And so it is critically important that we continue to make progress to our dwell goals of 1 year out, 2 years back, for the Active force; 1 year out, 4 years back, for the Guard and Reserve. Because of our growth and the drawdown in Iraq, even with the plus-up in Afghanistan—and our portion of that plus-up is about 20,000—we will get 70 percent of the Army to our goal of—Active Army to our goal of 1 to 2 by 2011; and 80 percent of the Guard and Reserve to 1 to 4 by 2011. The rest will get there in 2012. So that’s critically important for us. MODULARITY AND REBALANCE Third element I’d update you on is modularity. And you’ll remember, back in 2004, we came to the subcommittee and said we were a cold war Army. We weren’t organized into formations that could be organized to deal with the threat that presented itself. We were designed to face a Warsaw Pact threat. And we have been progressing ever since. Well, we are 90 percent of the way through converting all 300 brigades in the Army to modular designs, and we will largely finish that by 2011, which was our goal. The other element of organizational change is rebalancing. We had a lot of skills that were needed in the cold war, but were not necessarily as needed today. And we’ve converted over 200 tank companies, artillery batteries, air defense batteries, into civil affairs, psychological operations, special forces companies. So that change has been going on. So together, modularity and rebalancing—largest organizational change of the Army since World War II, and done while we’ve been 28 deploying 150,000 soldiers over and back to Iraq and Afghanistan every year. Next element of balance, we feel we can get more out of our force if we organize it on a rotational model, much like the Navy and Marine Corps have been on for years. And we’re moving toward that, and it’ll pay great benefits. And last, restationing. With the base realignment and closure and the growth, we’re moving 380,000 soldiers, civilians, and family members all around the world, here, over the next few years, to complete that. But, the end result will be much better facilities for our soldiers and families. So, that’s an update on rebalancing. With your support, we expect to largely complete what we set out to do in 2007, and be in a much different position by the end of 2011. And this budget is what gets us there. Still got stresses and strains, as the Secretary said, and not out of the woods yet. Now, if I could, just three quick priorities: Sustaining soldiers and families. They’re the heart and soul of this force. Two years ago, we doubled the amount of money we were putting toward soldiers and family programs. We’ve sustained that, and this budget continues that effort. Second, reset. This budget contains almost $11 billion to reset about 30 brigades worth of equipment. That’s, one, absolutely critical to sustaining the operational ready rates in the field in Iraq and Afghanistan, and to the long-term health of the force. And as we come down—draw down in Iraq, all that equipment has to go through the depots and get reconditioned before it’s put back in the force. And I worry that people will say, ‘‘Yes, okay, we’re out of Iraq, we don’t need money for reset anymore.’’ That’s not the case. MODERNIZING And then, last, modernization. As you mentioned in your statement, the FCS—future combat systems—program was terminated. And we have, in this budget, the beginning of a brigade combat team modernization strategy that we believe is both affordable and achievable. And that’s based on four elements: First of all, incrementally modernizing our network. And we do that incrementally so that we can take advantage of continuing growth in information technology. Second is incrementally fielding capability packages. In the future combat systems, we talked about spinouts, about capabilities that we could put into the force, ahead of the full system. We’ve refined that concept into capability packages, where we will incrementally put ready capabilities into the force as they’re ready, rather than wait for the whole system to be developed. Third, we’ve incorporated the MRAP, the mine resistant ambush protected, vehicles into our forces. There’s a significant investment in those vehicles, and we’ve incorporated them into the force. And then, last, this budget includes just under $1 billion of research and development effort for a new ground combat vehicle. And this vehicle will—is designed as a replacement for the Bradley. It is an infantry fighting vehicle, and it is the first infantry fighting vehicle designed, from the ground up, to operate in an improvised explo- 29 sive device (IED) environment. And it will become a very important element for us. I’ll close with saying that I share your pride in what the men and women of this Army are doing around the world every day. I couldn’t be prouder of them. And so I’d look forward to taking your questions. Thanks very much. Chairman INOUYE. Thank you. Senator Brownback. Senator BROWNBACK. No, Mr. Chairman, I don’t have a statement to make. I would like to put one into the record. And I certainly thank our two presenters here today. And I look forward to making a couple of questions when my turn comes. Chairman INOUYE. Without objection, your statement will be made part of the record. [The statement follows:]

PREPARED STATEMENT OF SENATOR SAM BROWNBACK Mr. Chairman, I thank you and am pleased to attend my first Senate Appropria- tions Subcommittee on Defense hearing. I welcome Secretary McHugh and General Casey and look forward to your testimonies. On behalf of my state, I would like to thank the Secretary and General Casey for their commitment to the military men and women in Kansas, particularly at Fort Riley and Fort Leavenworth. The Army faces a number of major challenges covered in the prepared statements of today’s witnesses. In particular, however, I would like to focus on the subject of warrior care and our commitment to soldiers and families. First, I applaud the Army’s new Comprehensive Soldier Fitness program, an all- inclusive approach to emotional, social, spiritual, family, and physical fitness, to build resiliency within the Army. Recently the Army began a brain mapping program and I encourage these types of efforts to more fully understand the effect that trauma and injury can have on the functionality of the brain. These efforts could be a huge step in the right direction in suicide prevention and drug and alcohol abuse prevention. I also want to commend the Army for their collaboration with the National Institute of Mental Health on suicide prevention and I look forward to the benefits we as a society can gain from the research and programs the Army imple- ments. Next, I would note that the budget provides $1.7 billion to family programs and services and I commend the Army for making these programs an important part of its budget. The Army is built on the backs of the families of its soldiers. I am pleased with the commitment the Army has made to the military family and I encourage the continued investment in support services to these families. The implementation of the Army Strong Community Centers is a needed service for those family members of the Army Reserve who so often do not have a physical base to call home. In particular, I want to highlight a couple of items worth of additional attention from the Army. First, following the example in Illinois and other facilities, I encourage the Army to look at joint VA/DOD hospitals to streamline care and provide the best medical services to military members, their families, and military retirees. A related issue involves transitioning our active duty soldiers into the VA system. There are several pilot programs that attempt to seamlessly transition active duty soldiers into the VA system but they have had limited success. Obviously, the new electronic medical records will be a huge step in help transition a soldier from DOD to the VA. However, the disability rating system is still too slow and behind the times. I ask that you work closely with the VA to ensure these soldiers are getting the proper care and benefits they are entitled to. I also want to highlight an emerging problem at Fort Riley, in my state, as well as other Army posts: school overcrowding. Fort Riley is again the home of the headquarters of the First Infantry Division and the combination of that move with other BRAC and Grow the Force decisions has led to a dramatic expansion of this post. I am very proud that the surrounding communities stepped up to the plate to prepare for the thousands of soldiers and family members arriving in the area. But after exhausting their bonding capacity to provide classroom space off-post (which has already been filled), the local communities lack the ability to handle a much 30 larger than anticipated on-post student population. I know that the Army and the Department of Defense are not usually in the business of school construction, but I also know that Fort Riley is not the only installation facing this problem. Other posts are now or will soon face similar issues, and we have to find a way to make sure these children have a place to go to school. It is a huge concern in the Fort Riley school district, a top priority of Major Gen- eral Brooks, who commands the First Infantry Division, and something that I intend to prioritize during the upcoming appropriations process. I hope to learn more from the Army about what can be done to address this concern. Again, I thank the panel for their time and look forward to hearing how the Army plans to use this budget to meet the needs of our nation’s military. Chairman INOUYE. Gentlemen, I have a few questions. I’d like to submit the rest because of the technological nature of the questions. They refer to the Stryker, the cargo ship, and your program on balance. STRESS ON THE FORCE But, at this stage, may I ask—as noted by all the witnesses and everyone that has gone to Iraq and Afghanistan, if they would say that the troops are under great stress? And, as such, we have noted suicide rates rising, alcohol abuse, and divorce rates. And you have provided additional mental health providers and launched a suicide prevention education program. Can you give us an update, Mr. Sec- retary? Mr. MCHUGH. I can, Mr. Chairman, and I appreciate your starting with this question, because obviously it goes to the core of the stress and the pressure under which these brave soldiers have been for the last 8 years, but it also shows, I think, the extent to which it reaches beyond the soldier into the family structure. I think it is one of the most important things we’ve done—I want to start by giving a tip of the hat to the Chief, and to my predecessor Pete Geren—who helped establish the program called comprehensive soldier fitness. This is a program that was started to try to provide resiliency training—to provide resiliency trainers to go out, throughout the force. And perhaps the Chief would like to comment further. But it allows people the opportunity, on an anonymous basis, through computer technology, but in a very real way, to find particularly tailored programs to help them cope. And that’s a great start. BEHAVIORAL HEALTH But we have to get down on the ground on a one-to-one basis. And, as you noted, Mr. Chairman, we’re working very hard to try to expand the wide range of programs, including a dramatic plus- up in behavioral health specialists. In fact, now we see, in forward- deployed positions, the availability of behavioral health specialists, which is rated, generally, the ideal of one to every 700 troops. We’re actually below that level now, but we’re continuing to grow to that. Like what happens in the private sector, of course, growing that cadre of specialists has been a challenge, but I think we’re making good progress. With respect to suicide, the Vice Chief of Staff, General Pete Chiarelli, has taken that under his wing and, I think, has done a terrific job in establishing a way forward to try to provide stress release, to try to keep a better assessment, the pre- and during and 31 post-assessment surveys that are required now, as mandated by this Congress, for each soldier, so we can, hopefully, identify problems that—as they emerge, to engaging in a pretty revolutionary 5-year longitudinal study, for the cost of $55 million, with suicide specialists and the National Academy of—National Institute of Mental Health, rather, to try to understand the causes of suicide. The specialists tell us that the exciting thing about this is, they feel it will have application to the factors behind those who find themselves in a position of choosing suicide in the civilian sector, as well. We will receive reports, on a quarterly basis, to try to make sure that we’re implementing hopeful and developing procedures to try to do a better job. So, whether it’s alcohol abuse programs, with more money, more counselors, more availability; mental health; military life; family consultants; people to talk to; people to go to, to try to receive more help—we’ve taken a very holistic approach to this. We’re doing a better job, but, as you noted, Mr. Chairman, the stresses continue, and those stressor indicators, across the board, continue to be troubling to us. Chairman INOUYE. General, would you care to add to that?

SUICIDE

General CASEY. If I could, Chairman Inouye. Frankly, I’m personally frustrated with the effort that we have put on this over the last 3 years, and then particularly over the last year, that we haven’t stemmed the tide. And we’ve increased by about 18 suicides a year since 2004. In this past year, with all the effort we made, we increased by about 20. And as I looked at this over the past years, it was clear that we were shooting behind the target with a lot of these programs. And that’s why we instituted the Com- prehensive Soldier Fitness Program, to give the soldiers and family members and civilians the skills they need on the front end to be more resilient and to stay away from suicide to begin with. It’s a long-term program, but I think that is the only way that we are ultimately going to begin to reduce this. And the last thing I’d say is this is not just an Army problem. There was an op-ed in The Washington Post this morning talking about the impact of suicide in society; we all have to go at this together. I think this National Institute of Mental Health study that we’ve done is going to help everybody. Thank you. Mr. MCHUGH. Mr. Chairman, can I add just one point? We know, both intuitively and, as the chief mentioned in his comments, by the findings of the mental health advisory teams that we employ, that the operations and personal tempo—OPS and PERSTEMPO— and the boots on the ground (BOG)/dwell inadequacies are critical, across the board, to all of those stressor indicators, and suicide is primary amongst them. So, as we continue to do a better job on keeping people back home between deployments, we’re hopeful that’ll have a positive effect on the suicide rates, as well. Chairman INOUYE. I thank you very much. 32

STRYKER General, I’d like to ask a few questions on the Stryker. We’ve been watching media reports from Afghanistan that suggest that these Strykers are quite vulnerable to the explosive devices; and also they suggest that the Strykers’ weight may be a bit too heavy to give it the necessary mobility it needs in this Afghanistan theater. What are your thoughts on this? General CASEY. Well, as you can imagine, Mr. Chairman, we’ve been watching this very carefully for some time. And, the Stryker Unit that went into southern Afghanistan ran into some pretty heavy IEDs—I mean, hundreds of pounds of explosive weight—and, it did suffer some significant casualties. We’ve been working very hard on this, over time, to increase the survivability of the Stryker. I will tell you, it is more survivable than the up-armored Humvee and less survivable than the mine resistant ambush protected (MRAP), and we knew that, going in there. Before we sent it in, we implemented a number of survivability enhancements to the vehicle, and we are in the process of evaluating whether those are enough to operate in an IED environment. We are actually in the process of exploring a V-shaped hull kit, much like we were developing for the manned ground vehicle with the Future Combat Systems Program, that could enhance the survivability of the Stryker against underbelly improvised explosive devices. But, again, we’ve implemented a range of different options to enhance the survivability. I’m less concerned about the weight and the decrease in mobility. The Strykers have been remissioned, actually, to a mission of road security that actually takes advantage of the mobility that they provide. Last thing I’ll say is, they served for me in Iraq in an IED environment, and we were not nearly as challenged in that environment as we were in Afghanistan. So, it’s still a very important vehicle in an element of our force mix. Mr. MCHUGH. Well, the only thing I would add is that, as we’re finding in these theaters, not all equipment fits in all circumstances. The Stryker, something that I was a big supporter of when I was on the Armed Services Committee, has proven to be enormously effective. It’s had 11 successful deployments in these two theaters, and we expect more. In terms of the feedback from the commanders forward-deployed, they view it as a very valuable resource. Can we make it better, more survivable? As the Chief mentioned, we’re doing that on a variety of R&D programs. And the V hull—double V hull is preeminent amongst them. But, we think this is a very important program, and we have a great deal of confidence in it. RECRUITMENT Chairman INOUYE. Mr. Secretary, we’d like to congratulate you on your recruiting program. You have recruited all the numbers you need, and the quality of personnel. My question would be, can you maintain this trend? And are you funded sufficiently? Mr. MCHUGH. The answer to the first question, sir, is, we hope so, and we’re working to try to make sure that happens. General 33 Ben Freakley, who’s the head of our Accessions Command, I think has done an amazing job. But, the most effective thing he’s done is to try to recognize that we, in our recruiting and retention efforts, are, to a very significant degree, the beneficiaries of this economy. As Americans, we hope the economy turns around quickly, but that will change the environment in which we send out these recruiters and bring people—young people into the force. And we’re trying to prepare and revamp and refigure our efforts and our programs to be prepared for that. The money, for the moment, is significant. One of the major complaints I had, when I was chairman of the Personnel Subcommittee in the other body, was that we had an up-and-down on recruiting resourcing. And you have to maintain, in my humble judgment, a certain level of consistency to make sure you’re not eroding away your base, not eating your seed corn. Now, it’s totally appropriate, in this environment, that we cut back on some of the inducements, some of the bonuses we’re paying. They’re not necessary in this environment. But, we have to maintain that. I’m hopeful we’re going to do that, I think we’re poised to do it, but we’ll have to keep a very close eye on it in the future. Chairman INOUYE. I thank you, sir. General CASEY. If—Mr. Chairman, if I could. Chairman INOUYE. Yeah. General CASEY. To your point about stress on the force we measure a lot of things to tell us about whether the force is under stress. And it is. But, also to alert us that we may break the force. Last year, over 260,000 men and women enlisted or reenlisted in the Army, the Army Guard, or the Reserve. That’s a very positive indicator of their commitment and their willingness to continue to serve. Chairman INOUYE. Mr. Secretary and General, I’ll be submitting for your consideration questions on the brigade combat team modernization, on the future role of the MRAP, the Aerial Scout helicopter; the question on SDS, and the question on joint cargo aircraft. As you know, we are attending the memorial services for our great friend, and a great patriot, the Congressman from Pennsyl- vania. So, if I may, at this stage, call upon Senator Shelby. Senator SHELBY. Thank you, Mr. Chairman. STRYKER I’d like to pick up on the area dealing with the Strykers, and so forth, that the chairman was getting into. It’s been my understanding, from serving on this subcommittee many, many years, and the Armed Services Committee, before this, when they were developing, you know, the Stryker. The Stryker has been very good in a lot of areas, as the Sec- retary alluded to. The question, I guess, now, General Casey, is, How long would it take, if we do go a double V-, or something like that, -shaped hull on the Stryker, to give them the MRAP-like protection, give them more protection? Because our troops need that in Afghanistan. And where are you in that regard? 34

General CASEY. I can’t tell you exactly how long it’s going to take—— Senator SHELBY. Okay. General CASEY [continuing]. Because we’re in the early design stages of it. But, we are moving rapidly to get it built, tested, and into the hands of the forces as quickly as we can. Senator SHELBY. But, from an engineering standpoint, it looks to me, from what I’ve been briefed on, that that could be a probability, more than a possibility, to do this stuff. In other words, to reequip and make the Stryker more safe. General CASEY. Absolutely. In fact, as I said, we developed a V- shaped hull kit for the manned ground vehicle, the future combat systems vehicle. So, the technology is out there, and it’s available. And, I think it has great promise. Senator SHELBY. Thank you. Do you agree with that Mr. Secretary? I know you—you’ve been a supporter of the Stryker—— Mr. MCHUGH. Yeah—— Senator SHELBY [continuing]. As I have. Mr. MCHUGH [continuing]. I have, and—although the environment has changed dramatically. That’s not a step—— Senator SHELBY. You have to—— Mr. MCHUGH [continuing]. Back—— Senator SHELBY [continuing]. Change with it—— Mr. MCHUGH [continuing]. From—— Senator SHELBY [continuing]. Though, don’t you? Mr. MCHUGH. Yes, you—absolutely, sir. I think it’s worth noting that the manufacturer stepped out and recognized this early on, and has been working—not extrajudiciously, but been working on this and studying it for some time. And, that’s a great compliment to them, to recognize they want to keep this platform as relevant and as safe as possible. I’m optimistic, at this time, that we can field this. We’ve done it with the MRAP as a start-from-the-ground-up system, we have the Stryker out in the field. I’d like to think, and have enough faith in our engineering capability, that we can pull this off, and do it in a timely fashion. Senator SHELBY. If we can do that, though—the Stryker has a lot of utility that some of the other vehicles don’t have, right? Mr. MCHUGH. The commanders have told us, time and time again—and I just got back from my 15th visit to Iraq and 4th to Afghanistan—that they like and value this platform. Senator SHELBY. Yeah. We all do. General CASEY. If I—sorry. Could I just add—— Senator SHELBY. Yes, sir, General. General CASEY [continuing]. Something to this, because I think it’s important. I mentioned that the ground combat vehicle that we’re putting in this budget is the first vehicle designed from the ground up to operate in an IED environment. Senator SHELBY. That would take—— General CASEY. Each—— Senator SHELBY. That would take the place of the—— General CASEY. The Bradley. Senator SHELBY. That would succeed the Bradley. 35

General CASEY. That’s correct. But the issues that we’re having with the Humvee and the Stryker are all because they were developed not necessarily to operate in IED environments. So, we’re adapting as we go. UNMANNED AERIAL VEHICLES Senator SHELBY. Mr. Secretary, I’d like to get in the area of the unmanned aerial vehicles (UAVs), if I could, which is very important to the Army and to our soldiers. One issue that continues to be of concern is the Army’s ability to continue utilizing unmanned systems when and where our soldiers want to control them. I continue to hear, from our commanders on the ground, about the importance of the Army—of our commanders—retaining control of tactical UAVs. We’ve been through this before. I know that a great deal of our success in the theater hinges upon this capability, command and control. And I’m pleased that the Army has not lost many of these systems, due, in part, to the fact that the unmanned systems can land themselves. What I’m concerned about, Mr. Secretary—and I’ll bet you’ve been through this—you and General Casey—is enemies being able to back into these systems, like we saw with the Air Force Predator system last year. Could you describe what the Army is doing to mitigate this threat, if you can talk about it here, and also talk a little about the cyber initiatives that the Army’s pursuing in this area? Without getting into classified. Mr. MCHUGH. I appreciate your sensitivity there—— Senator SHELBY. Yeah. Mr. MCHUGH [continuing]. Senator. I think I can say, generi- cally—first of all, the Army greatly values, and, as you noted, sir, correctly, the commanders feel very strongly about the Army’s need to have these capabilities, particularly at a strategic level. The Army’s—— Senator SHELBY. And control, too, isn’t it? Mr. MCHUGH. Yes, sir. The Army is going forward with an unmanned systems program that starts with the extended range multi-purpose (ERMP), which is provided for in this budget, future development, right down to the Raven, which provides command- and-control opportunities for us, as well. As to what we read about in the press, I think I can say that all the services recognized that potential vulnerability early on, and have reacted very aggressively to it. And, for the moment, we feel comfortable as to the security systems in place. I’d be happy to go into closed session—— Senator SHELBY. Sure. Mr. MCHUGH [continuing]. And provide you—— Senator SHELBY. Whenever the chairman wants to get into that, sure. MI-17 HELICOPTER One last question, Mr. Secretary. The Mi-17 helicopters. The De- partment of Defense, as you well know, has spent about $1 billion of funding to noncompetitively purchase nearly 50 Russian Mi-17 helicopters for Iraq, Afghanistan, and Pakistan. I’ve expressed to the Secretary of Defense, not to you yet, as well as this sub- 36 committee, my grave concerns regarding the use of U.S. taxpayer dollars for Mi-17s, based on what we believe are false assumptions, a total lack of requirements and no analysis of alternatives. The Army has been very involved with the procurement of these helicopters. And until I raised this concern, last fall, it appeared that the Army was completely fine with funneling millions of dollars to the Russians to equip the Iraqis and Afghans, based on nothing more, as we understand it, than the fact that these militaries had once seen an Mi-17 in the area. I’d like to point out that the Mi-17s have an exceptionally high, as you well know, maintenance requirement, parts and services, and they’re not ready available for in theater. And the U.S. trade sanctions, I believe, were violated in the initial procurement. Finally, it’s also my understanding that this platform specifically violates the U.S. Army airworthiness requirements, document AR 70–62. The question—I’m getting to it, Mr. Secretary, slowly—now, that the Army has been designated as the lead service for the Mi- 17 procurement and has established a nonstandard rotary-wing program management office, why are there still no requirements or analysis of alternatives to this? And, if I could, Mr. Secretary, I’d like to just remind the subcommittee—our subcommittee, here—that the 2010 Defense appropriation bill requires a report detailing the current and anticipated demand for Mi-17s for Iraq, Afghanistan, and Pakistan; the anticipated availability or shortage of additional airframes; the sustainability of the airframe slated for use; an analysis of alternative airframes; and the future cost and funding sources available for procuring Mi-17—C–17s within 60 days of the enactment of the bill. That was 74 days ago, Mr. Secretary. Where are we, here? Mr. MCHUGH. After 5 months—— Senator SHELBY. That was a—— Mr. MCHUGH [continuing]. In the—— Senator SHELBY [continuing]. Long statement—— Mr. MCHUGH [continuing]. Building, I’ve had a—— Senator SHELBY [continuing]. I know that. Mr. MCHUGH [continuing]. Great time to analyze what your question suggests is a very complex problem, Senator. And, I would answer in this way. First, I would beseech you for the opportunity to sit down with you and to go into—— Senator SHELBY. Absolutely. Mr. MCHUGH [continuing]. Greater detail. Second of all, as I—as you stated correctly, and as I think it needs to be further expanded upon, this is a DOD-directed program. The Army has been—as you again correctly noted, been designated the lead agent and administrator on this, but that is to implement DOD policy. The procurement program is intended, and has been explained to me, to meet current and near-term needs on the battlefield. And both the Iraqis and Afghanistans have seen the Mi-17s. It’s been explained to me—— Senator SHELBY. Probably flying around. Go ahead. Mr. MCHUGH. It’s been explained to me that those pilots—and I know you understand the development of the personnel and the 37 specialists to serve in both the Iraqi and the Afghan security forces, to actually pilot and to do other specialty military occupational specialists (MOSs), in their ranks, is somewhat strained. But, in the near term, those who have seen it have also flown it and are prepared to operate in those particular platforms. You’re correct, as well, their maintenance scheduled needs are somewhat of high operations tempo, but in complexity they are somewhat simple, in that—and I’m probably the last person in the world to be talking about this, but—in that the mechanics and the opportunities for repair and maintenance are relatively routine. Having said that, and as a Buy American kind of individual, I think it’s totally appropriate, as we go forward, that we continue to assess the program. And at such time as it’s appropriate, when perhaps the theater needs growth, we reexamine exactly which way should—we should go in future platforms. But—— Senator SHELBY. Well, that would include alternatives as you analyze the needs, right? Mr. MCHUGH. As directed by the Department of Defense. And as everybody in theater, including the Iraqis and Afghanistans, get more sophisticated across the board, I assume their needs and their capabilities will expand. Senator SHELBY. Well, I’d like to meet with you sometime, and we’ll expand this a little bit further. Mr. MCHUGH. I’d be honored to. Senator SHELBY. Mr. Chairman, thank you. Chairman INOUYE. Thank you. Senator Brownback. Senator BROWNBACK. Thank you very much, Mr. Chairman. Secretary, General, good to see you. Let me start off just thanking you for your work you’re doing on the—both the suicide and post traumatic stress disorder (PTSD)— traumatic brain injury (TBI)—work. I think it’s—one of the startling things to me, when I came in as Congressman, was the number of veterans that we were having in our office and coming by that were having a lot of long-term difficulties from the Vietnam war and era. And I think one of the things we didn’t get on top of was what was happening to them mentally after they came back from combat. And I—boy, I see that thing playing out again, if we don’t get on top of it. And, it seems like the military’s recognizing that and saying, ‘‘No, something’s going on here, and we need to get on top of this.’’ Because, otherwise, you’re going to get a lot of long-term problems, difficulties. And it’s like almost anything, the sooner you get on top of it, the more likely you are to be successful with your options, and the more options you generally have available. So, I really applaud that. And I also applaud that I think we can find things out, here, that could be helpful to the broader society. Suicide rates in our young people is the third highest cause of death in teenagers. And you’re going, ‘‘You know, why on Earth is that?’’ You know, when you live in a great country like this, and opportunities that are here. But, you know, people really develop a thought that there’s just no hope. And when they get to that point in time, then options for doing 38 very drastic, dramatic, self-harmful things grows, and the more likelihood there is that it happens. You’re doing some work on brain mapping studies, that I’m a big fan of, because I think that may teach us what’s going on mentally, inside of a person. And the brain is the final frontier for us as a— as an organ. I mean, it’s just phenomenal, and it’s complex, and we don’t understand it very well. But, you guys’ work on this could really help us understand a lot of those complex inputs, and how they’re processed, and what happens. So, I really want to urge you, and support that effort. A final thought in this area, my own personal experience and view has been that the resources are available, but it’s that there are plenty of resources that are there, but generally when a person gets into this stage, they’ve blown through most of their relationships. They’ve blown through, maybe, a spousal relationship, family relationship, friends, and they’re on their own now. They’re alone in it. SUICIDE PREVENTION And that’s when you get in trouble, in that if there’s a way that we can look at encouraging those, or spotting the people when they start moving to a loner status, I’d—that’s, to me, the whole key of it. And that’s very hard to do. I think it’s on a front-end basis, where we try to encourage the building of more relationships, and be very systematic about it. You know, you’ve got a buddy program in the military, you’re always watching for the guy next to you. If there’s a way we expand that, get the volunteer community around these bases, around Fort Riley and places like that to do it; faith communities, very happy to step in and work in a relationship- building setting because I think that, at the core, is where we lose it. It’s not technology, it’s old fashioned ‘‘I care for you.’’ And having somebody there that actually cares for them, and through thick and thin, and when—this is generally when it’s getting really thin, and people self-treating places and ways, and I’ve seen plenty of it. And that’s at the core, but what you’ve got to get at is that relationship building. So, I really want to support that effort, because I think you can help us out in the broader society, and we need to address it as a military. I’ve got two narrow Kansas issues I want to push out to you. And this is, by virtue of the things you’ve identified here today, this is very small potatoes. So, you can look at it as such. They’re important to us. We’ve got two major Army installations, a number of Guard installations in the State. Fort Leavenworth, Fort Riley, we’re very proud of in our State, and we love them. And we really are very appreciative of those installations, those units. NEW MILITARY/VA HOSPITAL At Fort Leavenworth, there’s not a military hospital there. And I know we’ve looked at the numbers on this and said, ‘‘Well, it’s not a size, yet.’’ We do have the disciplinary barracks that’s there, we do have a small Veterans Administration (VA) that’s there. And I think it may be one, if you look into your future plans, that you may look at and decide a combined military/VA hospital might be 39 the way to go with this, because it’s got a large military community, a large military retiree community. I understand, in Chicago, you’ve done a combined Army/VA center. And in our future, I think we’ve just got to be less stovepipe and a lot more interconnected. And I think this may be a classic one where it actually could work pretty well and also fit the disciplinary barracks that’s there, too. [The information follows:] Recapitalization of the Munson Army Health Center, Fort Leavenworth, Kansas, is in the very early phases of planning. The next planning visit is scheduled for March 22–26, 2010 to clarify requirements and determine full replacement costs or program amount. The replacement project will compete in the Department of De- fense’s Capital Investment Decision Making (CIDM) process for likely programming in the fiscal year 2012–17 Defense Health Program Future Years Defense Plan. While the Army Medical Command and Department of Veterans Affairs (VA) have opened dialogue at the local level, the currently developed project that will be presented in this year’s CIDM is a modern 175,000 gross square foot replacement Army Health Center. Collaborative efforts between the Army and the VA concerning this project are not ready for consideration in this year’s CIDM process. Senator BROWNBACK. A second issue—and this, again, is a narrow one—at Fort Riley, with bringing the Big Red One back, which we are delighted to have—the community, the area, is just delighted their headquarters is back from Germany. We’re busting at the seams on our grade school, middle schools, with the numbers coming back in. And if you can look at if there’s any way to help out with that, because we want to make sure we provide a good family experience for these young men and women in uniform, and their families. And we’re having difficulty meeting that. So, as I say, those are small potatoes, relative to the other things. And overall, I want to commend you for what you’re doing in Iraq and Afghanistan. I think this military has performed very, very well. It has been tough circumstance, difficult to do, but I’m really proud of what you’re doing. I’m proud of how the military is operating. Thank you, Chairman. [The information follows:] The Army has no specific authority to fund public school construction. Chairman INOUYE. Thank you very much, Senator. Senator Dorgan. Senator DORGAN. Mr. Chairman, thank you very much. Mr. Secretary and General, thank you for being here. Let me ask a couple of questions. First, the issue of the Sky War- riors. I know that my colleague is very interested in that issue, and has been for some while. I have wondered aloud and questioned why we have almost identical programs run by both the Army and the Air Force: Sky Warriors, the Warriors, and the Predators. DUPLICATION OF SYSTEM And when I came to Congress, several decades ago, I joined a group then, with Senator Gary Hart, talking about trying to change the procurement process and try to stop the duplication. Because every level of service wants to do everything that everybody else does, and they’re pretty successful in making that happen. And as I watched the growth of the Predator and the Warrior program, it looked to me like you’ve got two branches of the service that have 40 done exactly the same thing. And I’ve been enormously frustrated by that. So, the question is, How will the Army Sky Warrior’s UAVs integrate with the 50 Air Force UAV caps that are planned for 2011? I mean, are you working with the Air Force trying to—tell—try to—— Mr. MCHUGH. We are, Senator. In fact, we have been for some time. In fact, I started working with ‘‘Buzz’’ Moseley on UAV employment a couple years ago. It’s not only the procurement side of it, it’s the employment side of it. And as we sat down, we realized that we were talking past each other a bit. If you look at the levels of war, it was pretty clear to us that the Air Force had the strategic UAV requirement. That was their baby, nothing for the Army in there. At the tactical level, that was really the Army’s purview, because we need to maintain pretty tight control so we can shift them around based on changing tactical situations. At the theater level, the operational level is where we were bumping up against each other. We worked with the Air Force to build a—we call it a CONOP, concept of operations—that gave the Air Force the higher—not altitude, but the higher-level requirements for the theater commander; and the Army had the lower- level operational requirements for the core commanders. I think we’ve done a good job of differentiating that. Probably not as much progress on the procurement side, in differentiating that. Now, we—these ERMP, that are basically enhanced Predators, that are in this budget, 26 of them, are somewhat different than the Predator. But, I ask myself the same question you do, Is it so much different that it ought to be a different program? And could we not gain efficiencies working with one program? And I have not cracked that one with the Air Force yet. Senator DORGAN. I hope you will, because I have thought there should be an executive agency for UAVs in the Pentagon so that we don’t have different levels of service doing the same thing, and duplicating the research, duplicating the management of the program, and so on. I—it is frustrating to see. And I understand that most services want to do everything, and even some things another service is doing. It’s been a battle we’ve fought for 30 years; mostly unsuccessfully, I’m afraid. But, thank you for that answer. I want to just mention to you that I’m going to ask the chairman, at some point—I’ve not had a chance to visit with him—but, in this appropriations bill, to include an amendment that will take a new and completely fresh look at whether deciding in LOGCAP to, essentially, contract everything out instead of doing it in the service, whether that has been an effective thing for the country—whether it’s producing food for troops, you know, under a contract, or buying towels for troops, or moving water to base. I happen to think that the LOGCAP, and the contracts under LOGCAP, have produced the greatest waste, fraud, and abuse, perhaps in the history of our country. I’ve done 20 hearings in the policy committee on this. Let me just go through a couple of them quickly. The contract to provide water to the military bases in Iraq, that contract resulted in nonpotable water at a number of the military bases being more contaminated than raw water from the Euphra- 41 tes River. And I had the internal documents of KBR that said this was a near miss, could have caused mass sickness or death. Both KBR said it didn’t happen and the Army said it didn’t happen. And yet, I got an e-mail from a commander, a woman, a physician with the U.S. Army in Iraq, saying, ‘‘No. No. I read these things. It did happen. I’m here. I’m treating patients as a result of that nonpotable water that is contaminated.’’ And I got the Government Ac- countability Office (GAO) to do—or the inspector general, rather, to do an investigation. He said, ‘‘Yes. In fact, it did happen.’’

BAD CONTRACTS And it kind of bothers me that—it bothered me then, and does now, that the contractor said it didn’t happen, the Army says it didn’t happen, and, in fact, when you investigate, it did happen. The sodium dichromate. We now have the Indiana National Guard and several others testing troops. Again, we had the person who worked for KBR on the site, who was a safety inspector, said he warned the contractor. Contractor denies all these issues. Electrocutions, you’re well familiar with. The contractors work on providing electricity. And wiring had to be redone, and we found massive mistakes. Soldiers have died. Mr. Maseth died, taking a shower, because of incompetence, hiring third-country nationals, that could barely speak English, to do the work. A man showed up, who worked in Saudi Arabia, who was doing part of what the Army used to do, he was ordering the supplies. He was ordering towels. And he held up a towel, he said, ‘‘Here is a towel I was going to order. My boss said no, that towel is not the one to order, I want you order this towel. It has our company logo on it.’’ He said, ‘‘Well, that’ll cost three to four times more.’’ His boss said, ‘‘Doesn’t matter. I mean, this is a cost-plus contract. We’re going to make more money.’’ So, he ordered the towel with the logo. And the list goes on and on. I mean, 22-year-old Mr. Diveroli gets $300 million in contracts. He’s a 22-year-old president of his dad’s shell company, and he hires a 26-year-old masseuse as a vice president, and gets $300 million in contracts. I had the head of your Army Sustainment Command in my office, and we had quite a talk. He said, ‘‘You know what? I’d do the same thing today, knowing what I knew then.’’ I said, ‘‘Well, then you wouldn’t—if I were running the Army, you wouldn’t remain in my Army.’’ But, all of those things suggest to me that there’s been something fundamentally broken in the procurement process, in the contracting process. In some cases, we even have contracted out contractors to supervise other contractors. I know some of that’s now going to change. I’m going to ask that we include an amendment, in this year’s bill, to take a fresh look at all that’s been done and evaluate if there is a better way to have done that, perhaps bringing some of those functions back into the Army? But, give me your assessment of all that, General Casey, and perhaps Secretary McHugh. 42

RESPONSE TO BAD CONTRACTS

General CASEY. Well, first of all, I think your efforts have shined the light on some things that needed a light shined on them. And all those things that you said, happened. But, I think we have learned from them, in advance. I mean, we’re not where we were 3 years ago, with contracts today. We actually—Pete Geren, in 2007, had an independent assessment of our contracting capability, and it was striking how much work we had to do. And since we’ve set up an Army Contracting Command with an Expeditionary Com- mand and a Mission and Installations Command, and we have more than doubled the number of trained contractor representatives that are out there to supervise these contractors. And we’re actively training soldiers in units before they deploy to give them the skills they need to do some of the oversight that was clearly missing in the cases that you saw. My sense is, your call to re-look this is timely. And it—I’m not sure how much of this is folklore, but when I talk to folks about this, what they tell me is, when we took the Army down, back in the late 1980s early 1990s, from 780,000 to 480,000, some—the mitigation for that was to be able to go to contractors to the logistical support. And way back then, they did—I’m sure they did cost-benefit analysis and costed the cost of a logistics soldier out over the lifecycle of the soldier, and they figured it was going to be cheaper to do contract for some of those logistical tasks. I think it’s high time that we go back and see if those assumptions are still valid. CONTRACTING CAPABILITY Mr. MCHUGH. Let me echo the Chief’s comments to you, Senator. And having served a number of years, and watching your efforts while I was in Congress, and a big fan of the military and the Army, I deeply appreciate it. And I think I can speak with some validity in saying that so do the men and women in uniform and their families. I agree with the Chief. We have taken steps to try to do the best we can within the framework that is provided. As you know, we’re transitioning to a LOGCAP IV that is different. I don’t want to suggest, at this early date, it is perfect, but it does do away with the sole-source and range of potential abusive practices that LOGCAP III did, but it may not be the perfect answer. And I assure you, the Army will administer and implement, to the best of its ability, whatever oversight structure that this Congress, in its wisdom, decides to place before us. I agree. Your final comment was about insourcing. We went far— too far, in my humble judgment. And I was part of the Armed Serv- ices Committee that supported those outsourcing initiatives that, perhaps well-intended, I think had difficult results. We’ve already re-brought into house, insourced, some 900 core capabilities that have provided the Army and the taxpayers $41 million in savings and, I would argue, better oversight. And we have an objective that is, in large measure, supported in this budget, to, by the end of 2015, insource to the Army another nearly 4,000. 43 Chief mentioned our efforts at the brigade and battalion level to provide well-trained and more sufficient numbers of CORs, contract oversight officers, and we’re going to continue to do that. But, my experience has been, there’s always a better way; the challenge is to find that. And to the extent we can be supportive in that search, we want to do that. Senator DORGAN. I know that the chairman wants to end the hearing; I think we have another engagement. But, I—let me just make one final point. First of all, thank you for your answers. I described some nega- tives; there are many, many positives. And I finished reading a book recently, and I think the title was ‘‘A Soldier’s Life,’’ and it is an extraordinary book about what soldiers do every day, and what our military does every day. And while I talked today about my concerns of some things, let me add what I’m sure you’ve heard from my colleagues, we are enormously grateful for the work both of you do on behalf of a lot of people today who got up this morning to face danger on our behalf. So, General Casey, thanks for your long service. Secretary McHugh, I’m glad you’re where you are. And thank you very much. Chairman INOUYE. I thank you very much, Secretary McHugh and General Casey, for your testimony. ADDITIONAL COMMITTEE QUESTIONS I have two questions here, submitted by Senator Cochran, who cannot be with us, so I will submit them for your consideration. We look forward to working with you in the coming months. And I can assure you that we will do our utmost to make certain that the men and women in uniform are given whatever is needed to make certain that their service to our country is not only one that our Nation would appreciate, but it will be good for them. And I commend you for the effort being made now to look into matters, such as stress, which is very important. [The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

QUESTIONS SUBMITTED TO HON. JOHN M. MCHUGH

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

BRIGADE COMBAT TEAM (BCT) MODERNIZATION Question. Secretary McHugh, the Army’s Future Combat Systems program, FCS, has been terminated and replaced with a program to incrementally field many of the technologies that were developed under the FCS program. However, a recent Limited User Test showed that despite an investment of almost $21 billion in the last 7 years, many of these technologies are unreliable and do not work as intended. This raises serious questions about the acquisition strategy pursued by the Army for FCS. What lessons has the Army learned from its FCS program acquisition strategy and how will you incorporate them into future Army acquisition programs? Answer. After cancellation of the FCS program, the Army conducted an analysis of requirements based on the lessons learned from the last 8 years of war. We retained the family of systems knowledge base acquired during the FCS program as well as technologies related to the network, and unmanned/ground vehicles developed during the program. This analysis will now support the BCT Modernization Strategy. We found that modeling, simulations and scenarios depicting FCS capabilities and operations became increasingly complex over time, which resulted in fewer scenarios 44 that limited our ability to analyze across a wide range of relevant operating conditions. A key lesson learned from this experience was that the Lead Systems Inte- grator (LSI) was contracted to produce analytical deliverables that were duplicative of what the Army was doing and that were more advocacy than analysis. These products were therefore of questionable value. Additionally, during critical early program stages, the unique technical expertise and capabilities resident within the Army were not leveraged by the Program Manager/LSI team, especially for platform survivability and the network. The Army has moved away from the LSI model and restructured the contract, establishing a Prime Contractor to deliver Increment 1 capabilities to our Brigade Combat Teams. While retaining the effort to integrate, develop and field capabilities as a system, the Army is also fully embracing competition and Department of Defense Instruc- tion 5000.2 to support our BCT Modernization strategy. For example, the Ground Combat Vehicle program will be competitive beginning at a Milestone A and using best practices, including competitive prototyping through its acquisition process. Further, FCS did not adequately revalidate operational concepts at regular intervals to address lessons learned or reassess technology development. The BCT Mod- ernization Plan will focus on technologically feasible and affordable solutions, address lessons learned, allow for incremental technological development, and have appropriate mitigation plans in place. For example, the Army will field Increment 1 capabilities only when they are mature and will structure the program to allow for technological upgrades and refinements even during the fielding process. Early in development, the Army decided to let Soldiers test and evaluate the systems through the Army Evaluation Task Force. As a result, Soldier feedback has played a key role in optimizing designs throughout the development phase—ultimately leading to a better end product. Increment 1 capabilities are now in their third year of the 4 year test cycle.

FUTURE ROLE OF MRAP VEHICLES Question. Secretary McHugh, a success story from the wars has been the rapid development and fielding of Mine Resistant Ambush Protected Vehicles, ‘‘MRAPS’’. The Army has taken receipt of 12,000 MRAPs and has a requirement for about 5,800 light-weight MRAPs. But despite the MRAP’s unquestioned success, I get the feeling that these vehicles are treated like the ‘‘ugly step-child’’. The Army has no funded plan to integrate them into its force structure, and you are developing another tactical vehicle that won’t deliver for several years. Mr. Secretary, given the difficult fiscal times and Secretary Gates’ guidance to focus on the 80 percent solution that can be provided immediately instead of developing gold-plated exquisite systems that don’t show up for years to come, what is the future role of MRAPs in the Army? Answer. The Army has developed an allocation plan for MRAPs as they return from theater. This plan, and associated courses of action, was briefed to the Under Secretary of the Army (USA) and the Vice Chief of Staff of the Army (VCSA) on December 22, 2009. The plan included placing MRAPs in task organized sets, select units, and the training base. The USA and VCSA directed the proponents to conduct a detailed cost benefit analysis on two courses of action for task organized set placement. The results of this cost benefit analysis will be presented to the USA and VCSA on March 25, 2010.

ARMED AERIAL SCOUT HELICOPTER Question. The fiscal year 2011 budget continues to modernize Army aviation units at a rapid pace. However, one key program, the replacement of the aging Kiowa Warrior helicopter, has been set back by the failures of the Comanche and the Armed Reconnaissance Helicopter. The Army is conducting new studies on how to replace the Kiowa Warrior and the studies are reportedly examining new concepts of ‘‘teaming’’ helicopters with Unmanned Aerial Vehicles (UAVs). However, it is not currently known how many years it will be before a prototype Armed Aerial Scout helicopter will fly. Secretary McHugh, the Secretary of Defense has warned about the dangers of pursuing exotic and costly weapons systems, while ignoring the 80 percent solution. Do you feel the Army is taking the right approach to the Armed Aerial Scout helicopter? Answer. In July 2009, the Defense Acquisition Executive directed the Army to conduct an Analysis of Alternatives (AoA) to meet Armed Aerial Scout capabilities and to determine a replacement for the OH–58D Kiowa Warrior. This AoA will determine the appropriate materiel solution(s) to address any capability gaps and meet Army requirements. The base for analysis is the current Kiowa Warrior, but 45 the review will also include ongoing improvements to the Kiowa Warrior as an option. The AoA will be conducted in two non-sequential phases with the preliminary results completed in December 2010 and final results published in April 2011. On April 14, 2009, the Secretary of the Army approved a strategy to reinvest in the Kiowa Warrior helicopter to address obsolescence and sustainment issues until a viable replacement is ready. The strategy includes a funded ACAT II program called the Cockpit and Sensor Upgrade Program (CASUP). The CASUP addresses obsolescence, safety and weight reduction so the aircraft performs better in the current combat environment. The Army expects to sustain the Kiowa Warrior until 2025.

ARMY FUNDS RUNNING OUT IN FISCAL YEAR 2010 Question. In fiscal year 2010, the Department of the Army was appropriated $141 billion in baseline funds and an additional $78 billion for an entire year of Overseas Contingency Operations. When the budget request was submitted last month, it included a fiscal year 2010 supplemental to send an additional 30,000 troops to Af- ghanistan. Much of those expenses are for Army operating costs and in total, the Army’s request to support the new policy is $20 billion. Secretary McHugh, with the current resources available to the Army in fiscal year 2010, how far do you think you can make it into the fiscal year before running out of funding? Answer. A critical portion of the fiscal year 2010 supplemental request is the Op- eration and Maintenance, Army (OMA) funding for increased operations in Afghani- stan. Because OMA comprises the majority of the Army’s funding, this account becomes the measure by which we project a run-out date at the end of June, beginning of July. Passage of the supplemental prior to Memorial Day would make funds available in June, and would minimize the risk of impact on theater operations, base operations support, readiness and family programs. It would enable the Army to maintain required execution flexibility across all appropriations.

JOINT CARGO AIRCRAFT Question. Secretary McHugh, I have a couple of questions on the C–27 Joint Cargo Aircraft—the plane that will replace the Army’s fleet of C–23 Sherpas. Last March, the Congress was told that the Army needed 54 of the 78 aircraft planned for procurement. In May, the Department announced that it would procure just 38 aircraft, less than half the number in the original plan, and transferred management to the Air Force. Has your staff reviewed the analyses which produced the lower requirement and are you satisfied that the Army’s lift needs will be satisfied with the planned buy of 38 aircraft? Answer. The Army has a validated requirement for 75 cargo aircraft, per the Joint Cargo Aircraft Analysis of Alternatives (AoA) and addendum. Office of the Secretary of Defense Program Analysis and Evaluation (OSD PA&E) completed a sufficiency review validating the Army’s acquisition objective of up to 75 aircraft. The Army’s initial procurement was for 54 Joint Cargo Aircraft (C27J). However, in April 2009, the SECDEF directed the Joint Cargo Aircraft (C27J) program be transferred from a joint Army led program to a single service Air Force program. He further reduced the initial joint procurement from 78 aircraft (54 for Army and 24 for Air Force) to 38 aircraft. The SECDEF has directed that the lift requirements be met by the Air Force, leveraging their entire fleet mix.

TACTICAL RADIOS Question. Secretary McHugh, the Army successfully incorporated commercial radio technology into the Joint Network Node system in the last decade. Is the Army planning to leverage other commercial technologies as part of the Joint Tac- tical Radio System? In particular, has Army looked at commercial technologies to meet the wide band networking requirements? Answer. The Army has leveraged commercial technologies to fill urgent operational capability gaps; however, there are no commercial alternatives to the JTRS programs that meet all the Joint Service requirements. Commercial off-the-shelf alternatives may offer an attractive up-front price over the JTRS programs; however, they only provide limited solutions and potentially make it more difficult for the DOD to achieve interoperability of our joint secure communications. Question. Secretary McHugh, what is the Army’s position on fielding additional AN/PRC–117G radios to meet contingency needs? Answer. In certain situations and missions, forces in contingency operations have expressed urgent operational requirements for a wideband networking radio capability. The Army Staff is currently analyzing each request carefully to determine the proper materiel solution for validated requirements. In some cases, the AN/PRC– 46

117G is the best solution available to satisfy these needs. The Army has sufficient stocks of AN/PRC–117G on hand to meet all known contingency operations requests, and plans to resource/field any approved requests from these stocks only. The Army is not currently planning to purchase additional AN/PRC–117G to meet contingency needs. The preferred approach is to accelerate Joint Tactical Radio System (JTRS) capabilities, wherever possible, to satisfy wideband networking radio requirements.

QUESTIONS SUBMITTED BY SENATOR PATRICK J. LEAHY

ARMY GUARD AND RESERVE EQUIPMENT Question. How much funding is included in the President’s fiscal year 2011 for Army Guard and Reserve Equipment? How does this compare to the relative size of the Army Guard and Reserve compared to the active duty Army? Does the Army support a separate budget line item that annotates equipment procurement for the Guard and Reserves? Wouldn’t this provide greater transparency? Answer. Funding requested for equipment procurement is as follows: $15 billion (76 percent) for the Active Component (AC); $3.6 billion (18 percent) for the Army National Guard (ARNG); and $1.1 billion (6 percent) for the U.S. Army Reserve (USAR). There are some deviations of funding versus size (based on requirements). However, a more telling comparison is requirements versus equipment on hand, which shows that we are funding to increase readiness in all components equally. The Army does not support a separate budget line item, as it would limit the Army’s fiscal flexibility, which is required in a constantly changing world. The Department of Defense (DOD) has provided the Services with implementation instructions on how to attain transparency. The instructions direct the Services to provide component-level funding data for the AC, ARNG, and USAR on annual budget exhibits. The Army has complied with this by providing the data on the P– 40 (Budget Item Justification) and the P–21 (Production) budget exhibits for both the fiscal year 2010 and fiscal year 2011 budget requests. The DOD instructions also direct the Services to provide quarterly reports that track the execution of Reserve Component funding and procurement. The DOD intends to provide those reports to Congress on a semiannual basis. The Army fully supports and is in compliance with the DOD implementation instructions and has provided the required reports for fiscal year 2009 and 1st Quarter fiscal year 2010.

DIRECTOR OF THE ARMY GUARD Question. In what stage of the nomination process are we for the position of the Director of the Army Guard? When can the Senate anticipate receiving a new nominee for this position? Answer. Currently, the Army and the National Guard are in the selection phase of the nomination process. The Senate can anticipate receiving a nominee as soon as the selection phase is complete, which is estimated to be within a few weeks.

HOMELAND RESPONSE FORCE Question. How will the Department of Defense organize Emergency Management Assistance Compacts between the state that owns a Homeland Response Force and the other states in the region that share it? Under what emergency circumstances would you envision Federalizing the Homeland Response Force and taking command and control away from the Governor in favor of U.S. Northern Command? Was the decision to establish the Homeland Response Forces made jointly by DOD and DHS? Answer. Emergency Management Assistance Compacts (EMACs) are arranged and entered into by the states and territories in order to provide mutual assistance and support of one another. They are not compacts with the Department of Defense. The Department is drawing on existing National Guard forces to build a Home- land Response Force (HRF) in each of the ten Federal Emergency Management Agency (FEMA) regions. Creation of HRFs within the existing National Guard force structure recognizes the need for increased Chemical, Biological, Radiological, Nu- clear, and High-Yield Explosives (CBRNE) response capabilities and capacity in the event of catastrophic CBRNE incidents. It also takes into account the operational experience states and territories have in supporting each other using National Guard forces in either State Active Duty (SAD) or Title 32 statuses. As is the case for the states that currently maintain National Guard CBRNE En- hance Response Force Packages (CERFPs), the Adjutant General of the state or territory that gets an HRF agrees in writing that the HRF is a national response capability, which can be employed outside of the state to provide support within the 47

FEMA region or in other FEMA regions, as necessary. The 17 existing CERFPs are employed in state, out of state, regionally and nationally to respond to CBRNE incidents regardless of the unit’s location. The HRF will have the same early, life-saving capabilities of the CERFPs (e.g., Search and Extraction, Decontamination, Emergency Medical, and Command and Control (C2)), as well as security and Brigade level C2 for synchronizing multiple CBRNE units. Each HRF will have approximately 566 personnel. States generally have jurisdiction over the welfare of their citizens. However, in many circumstances the President, by law, has preeminent jurisdiction to handle certain incidents (e.g., terrorism, most nuclear or radiological events and/or environmental impacts). He or she also may have the political/moral obligation to assist regardless of the nature/size of incident. Accordingly, it is essential to facilitate a unity of effort as Federal forces integrate with ongoing State responses. The HRF is designed to be employed in SAD or Title 32 statuses. Only in an extreme situation, such as a state’s incapacitation to govern and/or control the emergency situation (continuity of government/continuity of operations), is it possible that the President would Federalize the HRF and place it under the command and control of the Commander, U.S. Northern Command (USNORTHCOM). Historically, over 90 percent of all incidents are handled at the local level; approximately 6 to 8 percent involve state level engagement, and an even smaller percentages have a Federal response. As such, the Department does not envision the likelihood of placing the HRF into a Title 10 status under the command and control of USNORTHCOM. However, USNORTHCOM will command the follow-on CBRNE Consequence Management Response Forces (CCMRF) when requested to augment the consequence management efforts of State and local first responders, National Guard forces and Federal agencies by providing complementary and unique capabilities when the effects of a CBRNE event exceed their capabilities. The Department of Homeland Security participated in both the initial consequence management study and observed the Quadrennial Defense Review. FEMA provided information about Federal, state, and local consequence management capabilities for inclusion in the consequence management study. State involvement, in the form of the Adjutants Generals, was facilitated by the National Guard Bureau.

TITLE 32 LINE ITEM Question. In each of the past several years, the Department of Defense has paid for Title 32 funding requests for domestic disaster relief missions as requested by State Governors and approved by the Secretary of Defense. Naturally, paying for these much needed operations out of regular Army Operations and Maintenance accounts shortchanges other programs. Does the Army have plans to create a Title 32 line item in its Operations and Maintenance accounts? If not, why not? If such a line item already exists, please provide the identification numbers used in the Army budget justification documents. Answer. Under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, Public Law 106–390, October 30, 2000, DOD may be required to provide assistance to Federal agencies and state and local governments in response to major disasters or states of emergency declared by the President. In fiscal year 1990, Congress established the Defense Emergency Response Fund (DERF) to reimburse DOD for providing disaster or emergency assistance to other Federal agencies and to state and local governments in anticipation of reimbursable requests. The Treasury index symbol for the DERF is 97X4965 and was initially funded at $100 million. The purpose of DERF is to allow DOD to provide disaster and emergency relief assistance in response to natural or manmade disasters without depleting the funds it needs to accomplish its mission. DOD Financial Manage- ment Regulation (DODFMR), Volume 12, Chapter 6 provides for the policy and procedures governing the Defense Emergency Response Fund.

QUESTIONS SUBMITTED BY SENATOR PATTY MURRAY

NATIONAL GUARD AND RESERVES Question. Secretary McHugh and General Casey, the National Guard and Re- serves have been called upon to support the efforts in Iraq and Afghanistan. Despite their dedicated service they often come home to hardships, especially in the current economy. In the state of Washington, National Guard unemployment is over 14 percent vice the 9.5 percent unemployment rate statewide. In the last year there have been seven suicides with 70 percent of those tied to the Guardsman’s financial situation. 2,100 Washington National Guardsmen live at or below the poverty line as a 48 result of their employment situation. I am concerned for these soldiers mental and emotional well-being as they are returning from serving their country to possible unemployment and financial instability instead of a happy family reunion. What is the Army doing across the nation to help these National Guard and Reserve soldiers and their families when they return from deployment to financial hardship? Answer. The Army Reserve Yellow Ribbon Reintegration Program (YRRP) provides information, services, referral, financial planning and assistance, and other proactive outreach programs to Soldiers of the Army Reserve and their Families through all phases of the deployment cycle. The goal of the Yellow Ribbon Reintegration Program is to prepare soldiers and families for mobilization, sustain families during mobilization, and reintegrate soldiers with their families, communities, and employers upon redeployment. When a soldier or family member contacts the Army Reserve Family Programs Office for financial counseling or assistance, the staff will support the soldier or family member by providing the appropriate assistance and/or connect them to community resources based on individual needs. Local Army Reserve Family Programs personnel also provide referrals to professional financial counseling services for deploying soldiers and their family members. In-person financial counseling is now available in most locations through Military OneSource in partnership with National Foundation for Credit Counseling (NFCC). NFCC provides financial education and counseling services at hundreds of local offices nationwide. Military OneSource arranges for soldiers and family members to meet face-to-face with a financial consultant in their community. This program is specially designed to provide short-term, solution-focused financial counseling for service members and families, who may be experiencing a financial setback. Up to 12 counseling sessions per issue, per calendar year are allowed for each National Guard or Reserve soldier (regardless of activation status) and families located in the continental United States. For those unable to attend in-person counseling or who are in locations where in-person counseling is not available, Military OneSource will provide telephone consultations. Additional assistance for returning Reserve Component soldiers is available through the Employer Partnership Office portal. The U.S. Army Reserve created the Employer Partnership Office (EPO) of the Armed Forces with the goal of assisting soldiers and family members with access to employment when they return from deployment. Launched in 2007, the program expanded in 2009 to include the Army National Guard. EPO regularly participates in Yellow Ribbon Reintegration events, job fairs, Wounded Warrior events and visits to units to advise soldiers and family members of the hundreds of thousands of jobs available to them. Through EPO, service members have access to more than 500,000 jobs listed by nearly 1,000 employers who have partnered with EPO. Additional assistance includes personal contact with EPO’s Program Support Managers who serve as caseworkers, advising service members not only about employment listed on the EPO portal, but about in-kind services offered by many of our partners and military service organizations. Services include mentoring and career development, job counseling, resume writing assistance, how to negotiate salaries, how to dress for success, tips on how to succeed in positions which are competitive and how to find jobs that compliment their military service. Question. How has this affected the readiness of our National Guard and Army Reserves? Answer. Financial hardships, caused by possible unemployment for redeploying Reserve Component (RC) Soldiers, have not had a measureable impact on readiness. During the beginning OIF and OEF, RC readiness did decline. With the implementation of the ARFORGEN model and the additional resources provided by Congress for RC units, however, overall readiness has been steadily improving since early 2009. Question. How is the Army assisting these soldiers to improve their job skills to make them relevant and competitive in the current job market? Answer. In addition to the highly valued skills Soldiers learn in the military, the Army has a number of programs to assist Soldiers as they transition into the civilian workforce. One of the newest, and most innovative programs is the Employer Partnership Office (EPO) launched in 2007 by Lt. Gen. Jack C. Stultz, Chief, Army Reserve. The program was designed as a collaborative effort between employers and the Army Reserve to provide a continuum of career for our service members. In July 2009, the Army National Guard joined the EPO. Currently nearly 1,000 companies have signed non-legally binding memorandums of agreement with the EPO. Many of our partners are Fortune 500 and Fortune 1000 companies; others are nonprofit organizations who contribute in-kind support to our service members as they transition into or back to the civilian job market. 49

Through EPO, service members have access to program support managers and business partners who can assist with resume writing in order to capture the skills and talent these men and women earn while they’re serving in the military. Other services include interviewing skills and how to dress for success. EPO program support managers can identify partners who offer internships and apprenticeships or offer assistance with relocation or continuing education. EPO also regularly briefs Soldiers and families at events such as Yellow Ribbon reintegration events, Vet- erans events, Wounded Warrior events, job fairs and briefings to individual units. Many of the skills that reside in the Reserve Components are shared skills Soldiers use in their civilian employment such as the medical field, transportation, city planning, management and military police. Due to these shared skills, through the EPO, we are currently developing pilot programs that would provide cross-training opportunities. One such program to be unveiled in the coming months represents a partnership between a major American automotive manufacturer and EPO to offer RC Soldiers an opportunity to train on the manufactures’ fleet training package. In the second phase of this pilot, the partnership will embed Soldiers in industry to train as mechanics on hybrid vehicles before hybrid vehicles are used on the battlefield. Additionally, we are reviewing ways in which a Soldier can earn credit towards a Commercial Drivers License (CDL) while learning to be a truck driver.

FAMILIES Question. Secretary McHugh and General Casey, I applaud your efforts in making the families of our soldiers a top priority. Family readiness and support is crucial for the health of the Army. The health, mental health and welfare of Army families, especially the children has been a concern of mine for many years. This also includes education, living conditions, and available healthcare. How are you meeting the increased demand of healthcare and mental health professionals to support the families? If not, where are the shortfalls? Answer. The Army listens to Family members who want easier access to care. At- tempts to improve access to care include two new Army programs associated with the new Child, Adolescent and Family Behavioral Health Proponency (CAF–BHP). The CAF–BHP focuses on two new innovative clinical programs to bridge the access gap: School Behavioral Health and Child and Family Assistance Centers (CAFAC). Breaking tradition, the School Behavioral Health program proactively brings care to the children rather than requiring them to travel to the clinic in the military treatment facility. Similarly, the Military and Family Life Consultant program provides care closer to where Soldiers work and Families live. Clinicians provide short- term, situational, and problem-solving consultation services outside the walls of the clinic, which breaks down some of the traditional barriers to care. The CAFAC is a model designed to be established at the installation level. The CAFAC brings together under one ‘‘roof’’ all the services on an installation providing for Army Fami- lies who are experiencing the stress of multiple deployments. This model creates a single point of entry for family members seeking help, thus allowing for more effective triage and efficient allocation of behavioral health resources while increasing access to care and reducing the associated stigma. However, due to the national shortage in Child Psychiatry, shortfalls remain and we are having difficulty filling the numerous Child Psychiatry provider vacancies throughout the Army. As a result of these shortages, some locations experience an inadequate number of therapists to help Families during the deployment cycle. The Army is continuously working to improve both military and civilian provider recruitment and retention. Recent incentives, including bonuses and relocation allowances, aid in these efforts. Question. What improvements have been made with respect to the children of soldiers and meeting their special requirements? What programs have you implemented to assist the children of servicemembers with coping with frequent deployments, re-integration, and other stresses of military families? Answer. The health and welfare of our children is tremendously important to the Army, and we recognize the difficulties frequent deployments cause. As a result, the Army has taken great strides by creating and bolstering numerous Child, Youth, and School Services infrastructures, programs and services to help our children cope with the full spectrum of the deployment cycle. Army Families receive reductions in child care fees during the deployment cycle and Child Development Centers have extended operating hours. They offer many options to support Family Readiness Groups and the Chaplains’ Strong Bonds program. No-cost respite child care has increased from 5 to 16 hours per child, per month. 50

Operation Boots On and Operation Boots Off help children understand and prepare for their parents’ deployment and redeployment. Child Behavioral Health Con- sultants are embedded in our programs to provide social, emotional, and behavioral support for both children and staff. Military Family Life Consultants provide non- medical, short term, situational, problem-solving counseling services in schools with high military-connected populations. Army School Liaison Officers serve as advocates for military-connected students and assist them through school transitions and with school-related issues. Academic support services help students compensate for parental absences with on-post homework centers, and 24/7 online tutoring support for students regardless of where they live. Army-sponsored Community Child Care Programs such as Operation Military Child Care and Military Child Care in Your Neighborhood provide fee assistance to geographically dispersed Families to reduce out-of-pocket child care expenses. Oper- ation Military Kids coordinates networks of citizens and organizations in every state to support military children impacted by deployment. Detailed information about these programs is available at the Army OneSource website, www.myarmyonesource.com. Question. Jobs have also been a concern of military spouses of deployed soldiers or who transition because of a Permanent Change of Station (PCS). Especially in the current job market, what is the Army doing to assist family members seeking employment after a PCS? What about spouses who must quit their job or reduce the number of hours worked caused by a deployment and the demands of the family? Answer. Families are important to the Army, a priority to soldiers, and a vital factor in the Army’s overall readiness. A prepared family is better able to manage deployment, long-term separations and Army life in general. The Army has a myriad of employment support programs that are geared towards our spouses, both Ac- tive and Reserve Component. The Employment Readiness Program provides assistance to family members in acquiring skills, networks and resources that will allow them to participate in the workforce and to develop a career plan. Employment services are available to all Army Components, regardless of location. Services include: career counseling and coaching; employment training classes; job fairs; Army Spouse Career Assessment Tool; job listings and information and assistance on the Military Spouse Career Ad- vancement Account. The Army Spouse Employment Partnership (ASEP) is an expanding partnership that is mutually beneficial to the Army and corporate America. ASEP consists of a small group of committed partners from the private sector, military and Federal government that have pledged their best efforts to increase employment and career opportunities for military spouses. The partnership provides spouses the opportunity to attain financial security and achieve employment goals through career mobility and enhanced employment options. The Dependents’ Educational Assistance (DEA) Program provides education and training opportunities to eligible dependents of deceased and/or permanently disabled veterans. DEA reduces tuition by offering up to 45 months of education benefits. The Stateside Spouse Education Assistance Program (SSEAP) is a need-based education assistance program designed to provide spouses of active duty and retired Army Soldiers, and widows(ers) of Army Soldiers who died either on active duty or in a retired status, and residing in the United States, with financial assistance in pursuing educational goals. The program assists spouses/widows(ers) in gaining the education required to allow them to qualify for increased occupational opportunities. SEAP provides for up to $2,500 maximum per academic year for fees, supplies, or books. In addition to these Army programs, many communities partner with their local installations through the Army Community Covenant and host job fairs and job centers to help spouses with employment searches, resume writing, interviewing techniques and other services to help them find meaningful employment. More detailed information on all of these programs may be found at the Army OneSource website, the Army’s online resource for information on programs, services and support available to soldiers and their families. 51

QUESTIONS SUBMITTED BY SENATOR THAD COCHRAN

RESILIENCY OF THE FORCE Question. Secretary McHugh, I have been informed that a third of the suicides this year have occurred at Fort Hood and Fort Carson. What measures are being taken alongside the Army Campaign Plan for Health Promotion, Risk Reduction and Suicide Prevention to address additional stressors at these two forts? Answer. As of March 2010, Fort Carson and Fort Hood each had 4 suicide deaths. These two posts account for 24 percent of Active Duty suicide deaths this year (33). At this point last year, the Army had 53 suicide deaths. The Army’s senior leadership is committed to sustaining our current emphasis on this problem. The Army conducts an extensive review of every suicide death to improve our understanding of why Soldiers choose to take their lives. The Army’s Suicide Preven- tion Task Force has created a standardized 37 line report that units use to analyze the factors surrounding each Soldier’s suicide. Within 30 days after a Soldiers death, this report is sent to Headquarters Department of the Army for review, and a Gen- eral Officer must ‘‘back brief’’ the Vice Chief of Staff of the Army during a monthly senior review board meeting. This back brief is done via a world-wide video tele- conference, so that leaders across the Army can share lessons learned and improve early recognition of at-risk Soldiers. Additionally, the Army Public Health Command (Provisional) has created the Army Behavioral Health Integrated Data Environment (ABHIDE) database. This database provides a standardized, enterprise-wide capability designed to integrate information from legal, medical and personnel databases into a comprehensive health surveillance system to support mental, behavioral, social and public health activities. By increasing Soldiers’ access to behavioral health (BH) care and the reducing stigma associated with seeking such care, the Army hopes to positively impact the delivery of BH services in garrison. At Fort Carson, Mobile Behavior Health Teams (MBHT) were created to meet this need. Each MBHT, which provides Soldiers with expedited BH evaluations and community-level treatment, can support a full Bri- gade Combat Team (BCT) (3,000–5,000 Soldiers) and has a licensed BH provider assigned exclusively to each battalion (500–600 Soldiers) (BCT). This system provides a single point of entry into BH care for Soldiers and a single point of contact for leaders with questions. The U.S. Army Public Health Command (Provisional) has evaluated similar BH outreach initiatives at other Army installations, such as Fort Sill’s Outreach Program in Oklahoma, and is currently conducting a full program evaluation of MBHT. Preliminary results suggest a downward trend in off-post referrals, wait times for Senate Appropriations Committee appointment and key suicide indicators. Efforts to measure the impact of MBHT on BH accessibility, provider trust, stigma and mission readiness are ongoing. A final report is expected in January 2011. Fort Hood’s Resiliency Campus focuses on wellness for its soldiers, families, and retirees. The campus is dedicated to integrating the body, mind, and spirit by aiding visitors in reaching individualized and measurable wellness goals through education and comprehensive programs. The Resiliency Campus is based on the idea of helping the soldier and the family before the crisis begins. Through a network of support services, the campus hopes to train and empower all soldiers and their families to be resilient, to continue fighting in spite of life’s challenges. Question. Secretary McHugh, are resources available to Guardsmen and Reserv- ists after they come off of active duty to help build resiliency? Is there outreach for their families when these soldiers return to a traditional Reservist role? Answer. The Army, Army Reserve and Army National Guard (ARNG) are working diligently to increase the range and quality of services provided to soldiers throughout the deployment cycle and beyond. Currently, there are limited resources available through the Yellow Ribbon Reintegration Program and the Comprehensive Sol- dier Fitness (CSF) Program. The Yellow Ribbon Reintegration Program contains outreach activities to help soldiers and their families with transitioning to a traditional role. In CSF, Master Resilience Trainers are being trained to teach resiliency to these soldiers. Soldiers and families can also use the ARNG’s Family Assistance Centers to help with reintegration. The ARNG is looking to increase its capability to train Master Resilience Trainers.

ARMED SCOUT HELICOPTER Question. Secretary McHugh, Secretary Gates has been critical of recent modernization efforts and has stated that too often we seek a 99 percent solution over a period of years rather the 75 percent solution over a period of months that’s re- 52 quired for stability and counterinsurgency missions. I don’t know what program or programs Secretary Gates had in mind when he expressed that view, but the last two Army efforts to replace the Kiowa Warrior helicopter fleet—the Comanche and the Armed Reconnaissance Helicopter programs—resulted in program terminations due to requirements growth, cost overruns and schedule delays. In response to these program replacement missteps, this Committee recommended the Army consider upgrades to existing in-service rotorcraft as a low-risk path to a Kiowa replacement. Mr. Secretary, I know you have been in your job for less than 6 months, so you may not have had time to consider the Committee’s recommendation. If you have had the time to consider the merits of upgrading existing in-service rotorcraft, would you share with the Committee your thoughts, and if you have not had time to consider this approach, would you personally look at this and get back to us with your thoughts? Answer. Considering the rapidly changing battlefield and new developments in Tactics, Techniques, and Procedures, existing in-service rotorcraft are receiving extensive modifications. Unfortunately, modifications often add weight, which has a negative effect on overall aircraft performance. An example is the aging OH–58D Kiowa Warrior fleet. Although the Kiowa Warrior has performed outstandingly in theater, there are materiel limitations. There are technology improvements, however, which are available to help address capability gaps on a new platform. On April 14, 2009, my predecessor approved a strategy to reinvest in the Kiowa Warrior until a viable replacement is procured. The strategy involves executing upgrades to the fielded fleet, weight reduction efforts and the Cockpit and Sensor Up- grade Program. This funded ACAT II program will address obsolescence, safety, weight issues in order to improve the aircraft’s performance in the current combat environment. We expect to sustain the Kiowa Warrior until 2025. The Army is also exploring all options to leverage existing and potential developmental solutions. In July 2009, the Defense Acquisition Executive directed the Army to conduct an Analysis of Alternatives to meet the Army’s aerial reconnaissance mission and determine a replacement for the Kiowa Warrior. The AoA will be conducted in two non-sequential phases with the preliminary results completed in De- cember 2010 and final results published in April 2011.

BRIGADE COMBAT TEAM (BCT) MODERNIZATION Question. Secretary McHugh, what are the lessons learned from the terminated Future Combat System program, and what steps are being taken to ensure they are incorporated in other Army modernization efforts? Answer. After cancellation of the FCS program, the Army conducted an analysis of requirements based on the lessons learned from the last 8 years of war. We retained the family of systems knowledge base acquired during the FCS program, as well as technologies related to the network and unmanned/ground vehicles. This analysis will now support the BCT Modernization Strategy. We found that modeling, simulations, and scenarios depicting FCS capabilities and operations became increasingly complex over time. This resulted in fewer scenarios that limited our ability to analyze across a wide range of relevant operating conditions. A key lesson learned from this experience was that the Lead Systems Integrator (LSI) was contracted to produce analytical deliverables that were duplicative of what the Army was doing and that were more advocacy than analysis. These products were therefore of questionable value. Additionally, during critical early program stages, the unique technical expertise and capabilities resident within the Army were not leveraged by the Program Manager/LSI team, especially for platform survivability and the network. The Army has moved away from the LSI model and restructured the contract, establishing a Prime Contractor to deliver Increment 1 capabilities to our Brigade Combat Teams. While retaining the effort to integrate, develop, and field capabilities as a system, the Army is also fully embracing competition and Department of Defense Instruc- tion 5000.2 to support our BCT Modernization strategy. For example, the Ground Combat Vehicle program will be competitive beginning at Milestone A and using best practices, including competitive prototyping through its acquisition process. Further, FCS did not adequately revalidate operational concepts at regular intervals to address lessons learned or reassess technology development. The BCT Mod- ernization Plan will focus on technologically feasible and affordable solutions, address lessons learned, allow for incremental technological development, and have appropriate mitigation plans in place. For example, the Army will field Increment 1 capabilities only when they are mature; but they will be part of an incremental process that will allow for technological upgrades and refinements even during the fielding process. 53

Early in development, the Army decided to let soldiers test and evaluate the systems through the Army Evaluation Task Force. As a result, soldier feedback has played a key role in optimizing designs throughout the development phase—ultimately leading to a better end product. Increment 1 capabilities are now in their third year of the 4 year test cycle.

MINE RESISTANT AMBUSH PROTECTED (MRAP) VEHICLES Question. Secretary McHugh, considering Mine Resistant Ambush-Protected vehicles are being incorporated into unit formations and the Army may maintain a presence in Afghanistan for a very long time, do you foresee an increasing production requirement for MRAP vehicles, and do you plan to look at maintaining a production capability instead of cycling production and the workforce between full production and idle production lines? Answer. Current MRAP production will end in December 2010, and no follow-on production is planned at this time. This will satisfy every known MRAP requirement received to date. However, given the evolving nature of the MRAP warfighting requirements, the Department is confident in the industrial base’s capacity and ability to respond to any future requirements. As of December 2010, 25,700 MRAP vehicles will have been produced to meet Joint Requirements Oversight Council (JROC)- validated requirements from all Services (19,368 for the Army). This includes 8,104 MRAP All-Terrain Vehicles (M–ATV), the latest MRAP variant designed specifically for the OEF environment. Of the 8,104 M–ATVs to be produced, 5,776 will be for the Army.

QUESTIONS SUBMITTED BY SENATOR MITCH MCCONNELL

SUICIDES Question. Congress has established a national suicide hotline for returning troops, as well as increased funding for mental health programs for active duty military personnel. However, there remain a high number of soldier suicides. For example, at least 11 suicides occurred last year at Fort Campbell. What preventative measures are the Department of Defense taking to address this problem? What, if any, legislative action would the Department need Congress to take to expand suicide awareness and education on posts? Answer. The Army has taken unprecedented steps to reduce suicidal behavior in both the Active and Reserve Components. Every day, the Army’s senior leaders address the issue of suicide prevention. For example, we conducted an Army-wide Sui- cide Prevention Stand-Down and Chain Teach (March thru July 2009), released an interactive and awareness training video and partnered with the National Institute of Mental Health to begin a 5-year study into risk and resilience factors. In 2010, we are continuing this effort by expanding the training for ‘‘peer to peer support’’ using the Ask-Care-Escort and other nationally-recognized suicide intervention models, developing new interactive and awareness training videos and increasing access to behavioral healthcare thru telemedicine initiatives. The Army fully supports the requirement set forth in the 2010 NDAA, which requires ‘‘person to person’’ behavioral health assessments for every Service Member upon their redeployment from an overseas operation. Finally, the Army is fully engaged with the Congressionally directed ‘‘DOD Task Force for the Prevention of Sui- cide by Members of the Armed Forces,’’ which is required to submit a report to Con- gress this summer providing recommended legislative recommendations to improve suicide prevention and awareness training and education. Army actions in 2009 to combat increasing suicide rates included the following: —Produced the interactive ‘‘Beyond the Front’’ training video. —Produced the ‘‘Shoulder to Shoulder: No Soldier Stands Alone’’ training video. —Updated AR 600–63 (Army Health Promotion) and DA Pam 600–24 (Health Promotion, Risk Reduction and Suicide Prevention). —Published Suicide Awareness Pocket Guide for all Soldiers. —Increased access to behavioral health and substance abuse counseling. —National Institute of Mental Health (NIMH) grant for the Army Study to Assess Risk and Resilience in Service Members (STARRS), $50 million/5 year study— quarterly updates to VCSA to accelerate lessons learned. —Tele-Behavioral Health screening pilot project with 25th ID, 100 percent screening thru face to face, VTC, or Computer Skype-like counseling. —Approved nationally-recognized best-practice suicide intervention skills training for Army use to assist in early recognition of at-risk individuals Army actions for 2010 include the following: 54

—Developing interactive ‘‘Home Front’’ training video. —Developing sequel to ‘‘Shoulder to Shoulder’’ training video. —Developing an Additional Skill Identifier for certified suicide intervention skills trainers. —Expanding Tele-Behavioral Health pilot project, evaluate effectiveness, and determine feasibility for using Army wide. —Developing program effectiveness measures. —Utilizing the Suicide Specialized Augmentation Response Team/Staff Assistance Team to support commanders by assessing programs, policies, and resources, and identify gaps to improve local suicide prevention programs.

COUNSELING SERVICES Question. With the current deployment schedule, a heavy toll is being placed upon the spouses and children of servicemembers. How accessible are counseling services for deployed servicemembers’ spouses and children? Are these services available on all major military installations? What programs are available for those living away from major military installations? Answer. Counseling services are available for deployed service members’ spouses and children on all major military installations. Spouses and children may access Military and Family Life Consultants through the Army Community Service by self referral, without having to provide a reason for seeking these services, or via Mili- tary OneSource. Military and Family Life Consultants are Licensed Clinical Social Workers, Pro- fessional Counselors, Marriage and Family Therapists, and Psychologists. They provide six free informal and confidential counseling sessions. No records are kept and flexible appointment times and locations are offered. Military and Family Life Con- sultants are also available to assist soldiers who are experiencing difficulty coping with daily life concerns and issues. For those family members who do not live near a military installation, the De- partment of Defense developed Military OneSource. Military OneSource is a free information center and website where family members can seek assistance 24 hours a day, 7 days a week. Counseling is provided by phone or in person by Masters- level consultants on issues such as family support, emotional support, debt management and legal problems for up to 12 sessions at no cost to the soldier. Military OneSource can also assist with the identification of a consultant in the family’s local area. Military OneSource does not release information about users of the services, with the exception of issues of child abuse, elder abuse, spousal abuse and/or risk of harm to self or others. Military OneSource can be accessed at www.militaryonesource.com or 1–800–342–9647. Family Members may complete a free, voluntary online behavioral health self-assessment, and obtain referrals at www.MilitaryMentalHealth.org. This is an approach to assist soldiers and family members with identifying symptoms and getting assistance. It provides confidential and immediate feedback, as well as referrals to TRICARE, Veterans Administration Centers, and Military OneSource. In addition to the behavioral healthcare services offered at our military treatment facilities, the Army Medical Command recently established the Child, Adolescent and Family Behavioral Health Proponency (CAF–BHP). CAF–BHP, located at Joint Base Lewis McChord (JBLM), addresses Army-wide family behavioral health needs. Its mission is to support and sustain a comprehensive, integrated, behavioral health system of care for military children and their families. The CAF–BHP collaborates with national subject matter experts and professional organizations to develop and promote evidence-based behavioral health treatments for military children and their families. The CAF–BHP is developing media-driven information campaigns to address military culture and the stigma associated with seeking behavioral healthcare.

HOSPITAL Question. Ireland Army Community Hospital at Fort Knox is one of the oldest hospitals in the Army. With the new Brigade Combat Team stationed at the post, I am concerned over the state of the current hospital and its ability to meet the increased demands placed upon it. What is the status of the Army’s decision on whether and when to build a replacement? Answer. The Army ranks the Fort Knox Hospital replacement as our second highest priority, behind a significant addition/alteration project at Tripler Army Medical Center, Fort Shafter, Hawaii. However, the final decision to replace the 52-year old facility will be made by the Department of Defense (DOD). DOD Health Affairs uses a Capital Investment Decision Model (CIDM) process to rank order the consolidated military medical construction priorities for all three Services. The CIDM determines 55 the Services’ priority projects according to weighted and scaled criteria, and by assigning scores by a 12 member Tri-service Capital Investment Review Board. The results of the most recent CIDM for the fiscal year 2012–17 POM are expected in mid to late May, and will determine if and when Ireland Army Community Hospital is programmed for replacement.

PTSD/TBI Question. What are the typical steps taken to identify soldiers who may have post- traumatic stress disorder (PTSD) and traumatic brain injuries (TBI) to ensure they get the proper care? Are there any further legislative steps that Congress could take to improve screening and the delivery of care to soldiers with PTSD and TBI? Answer. Screening Army Soldiers for PTSD and TBI is intensive. The Army recently implemented new guidelines for identification and treatment of TBI in The- ater. Upon return from deployment, there is 100 percent screening for PTSD and TBI exposure using the Post-Deployment Health Assessment (PDHA). The PDHA is mandatory within 30 days following deployment. An enhanced version of the PDHA replaced the April 2003 version in January 2008. A panel of mental health experts constructed the PDHA questions, and periodically reviews it to ensure it meets the intent. Many soldiers experience an initial ‘‘honeymoon’’ period when returning from a combat tour, when symptoms do not manifest themselves immediately. Accordingly, we initiated the Post Deployment Health Re-Assessment (PDHRA) in 2005. The PDHRA occurs between 90 and 180 days post-deployment. A review and enhancement process has been underway for the PDHRA, and the January 2008 edition replaced the original 2005 version. In addition to the PDHA and PDHRA, the Army requires soldiers to complete a Periodic Health Assessment annually, which again screens for TBI and PTSD. Army Knowledge Online (AKO) now integrates all of these screening requirements with a readiness stoplight (i.e. red, green, amber) status, so both the soldier and his or her commander are aware when a screening is overdue. All primary care providers receive training in the identification of PTSD and TBI. As part of the Respect-Mil Program (http://www.pdhealth.mil/respect-mil/ index1.asp) all enrolled soldiers are screened for PTSD and depression. In summary, the typical soldier is assessed and reassessed for TBI and PTSD at several points throughout his or her first year back from combat, and periodically thereafter. The Army is fully engaged in screening, as well as research to improve early detection, care, and treatment. Additionally, we are working to further de-stigmatize help seeking behaviors and to protect Service Members from adverse career consequences. We do not request any legislative action.

BRIGADE COMBAT TEAM Question. With the recent addition of the Brigade Combat Team at Fort Knox, what is the Army doing to ensure that the installation is capable of deploying the unit with dispatch? Answer. Fort Knox is currently designated as a power support platform (PSP) with the mission of strategically deploying individuals and units from all Services to include Department of Defense civilian employees and Reserve Components. Even with the addition of an Infantry Brigade Combat Team, Fort Knox has sufficient capacity to support all deploying units. The Army is working on several methods to maintain Fort Knox’s ability to support deploying units, including Forces Command providing additional resources to support movement/deployment operations under Title 10 requirements. Additionally, future military construction projects will be programmed to improve Fort Knox’s services, infrastructure and deployment readiness as part of the Army Power Projec- tion Upgrade Program (AP3).

HOUSING BARRACKS Question. In light of heavy deployments, I am concerned that many installations, including Fort Campbell, are still housing soldiers in Korean War-era barracks. What is the Department of Defense doing to ensure housing is brought up to date to help increase morale for our already overly taxed troops? Answer. At Fort Campbell the Army presently has barrack construction projects underway and programmed for fiscal year 2011, 2012 and 2013. Completion of these projects will eliminate the need to occupy Korean War-era barracks at the installation. In 2008, the Army completed the Permanent Party Barracks Upgrade Program (BUP) using Army Sustainment, Restoration, & Modernization funding. BUP elimi- 56 nated many inadequate barracks through modernization of existing facilities where feasible. Additionally, the Permanent Party Barracks Modernization Program (BMP) is scheduled for completion in the fiscal year 2013 MILCON program. BMP Military Construction eliminates the Army’s barracks shortfall and eliminates inadequate barracks where modernization with Restoration and Modernization funding was not feasible. However, neither BUP nor BMP specifically address buyout of certain types of buildings. Facility modernization not included in BUP or BMP, typically involves gutting the building to its structural slab and columns then reconfiguring it to a 1∂1 standard and adds approximately 30 years to the life of the facility. The Army continuously reviews its capital investment strategy to validate the plans for replacement and sustainment of barracks facilities, a major feature in the Army Campaign Plan. These plans address Korean-War era, Vietnam-War era and any other barracks built before 1980.

BLUE GRASS ARMY DEPOT Question. Why is the Blue Grass Army Depot chemical weapons stockpile in central Kentucky not being monitored around the clock? Answer. The Blue Grass Chemical Activity (BGCA), which is subordinate to the U.S. Army Chemical Materials Agency, is in charge of the safe storage of chemical weapons at Blue Grass Army Depot. The stockpile is stored in earth covered steel reinforced concrete bunkers. The bunkers are in a secured area with intrusion detection, and armed guards on roving patrols providing surveillance 24 hours a day. The BGCA relies on multiple safeguards to monitor the chemical munitions stockpile to ensure public and workforce safety. These safeguards include monitoring in accordance with our Kentucky Department of Environment Protection permit, visual inspections and application of munitions lot leaker data from both BGCA and other chemical agent storage sites. These safeguards, as well as an active Chemical Stock- pile Emergency Response Program have been in place at BGCA and all Army chemical stockpile storage sites for decades. History has proven their effectiveness at protecting both the workforce and the public. Question. It is my understanding a directive, FRAGO 10–041, was recently promulgated mandating that several restaurant concepts at military bases in Afghani- stan be closed. What is the policy justification for this action? Why were some concepts chosen but not others? Might this limitation on food options have a negative impact on morale among our warfighters? Answer. FRAGO 10–041 was issued on February 3, 2010 by the United States Forces—Afghanistan Commander to implement a 60-day closure plan for specific commercial activities available in Afghanistan. This included all commercial fast food restaurants brought in by the Army and Air Force Exchange Service. Afghani- stan is a war zone, which has very limited ground routes into and within it. The Commander’s intent is to eliminate all non-mission essential traffic, because of higher priority cargo needing to be transported over those routes. Our forces have access to various high quality meals in military dining facilities and therefore commercial fast food restaurants are considered as non-mission essential. Furthermore, those fast food restaurants were only available to our forces operating on the larger bases. This decision levels the unequal lifestyle between those forward deployed and those living on fixed bases. We do not expect a significant morale issue to result.

QUESTIONS SUBMITTED BY SENATOR SAM BROWNBACK

SCHOOLS Question. Secretary McHugh, I wrote to you in December to raise the issue of overcrowding in schools on Fort Riley. The Army’s response to that question was that the issue is being studied, but in the meantime, the problem is getting worse. The community around Fort Riley has spent all of its available resources but can’t keep pace with the influx of students. For that reason, General Brooks, the First Infantry Division Commander, requested help from the Army and from the Depart- ment of Defense to address the overcrowding problem. I also understand other installations that gained forces under the most recent round of BRAC, such as Fort Lewis in Washington, face similar problems. What is the Army’s plan to handle this issue? Answer. The Army has no specific authority to fund public school construction. However, we recognize that some of the school districts serving our military children 57 are experiencing school construction funding challenges, specifically, Fort Riley and Joint Base Lewis McChord (formerly named Fort Lewis), in Washington. To better understand the issues for all school districts serving our military Fami- lies, the Army recently completed a comprehensive condition and capacity inventory of all on-post schools in the United States. Results indicate that over 50 percent of the 122 on-post schools are in need of renovation or replacement. Our plan is to work with the Department of Defense, the Department of Education and the Con- gress to develop solutions for those districts that have exhausted local and state funding options. Please note that, although operated by the local school district, six of the seven schools at Joint Base Lewis McChord are owned by the Department of Education. Department of Education has the responsibility to fund necessary renovation or reconstruction for these schools, hence our need to work with them to develop solutions. Army owns the remaining school. Question. Does the Army require additional money to handle the issue of over- crowded schools at posts that gained forces through BRAC and Grow the Force? Was such funding included in the fiscal year 2011 budget request, and if not, why not? Answer. Public school construction is normally a state and local responsibility. Be- cause the Army has no specific authority to fund public school construction, we have not included such funding in the fiscal year 2011 budget request. Additional authorization and appropriation legislation would be needed for the Department of Defense to construct public schools. Question. Does the Army need any statutory changes to facilitate on-post school construction or modification? Answer. Yes, the Army would need a legislative change to assist local public school districts with school construction. One potential avenue would be through the use of American Recovery and Reinvestment Act funds specifically targeted to school districts that have been significantly impacted by Base Realignment and Closure or Grow the Army stationing decisions.

QUESTIONS SUBMITTED TO GENERAL GEORGE W. CASEY

QUESTION SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

EQUIPMENT IN THEATER Question. General Casey, the Army has massive amounts of equipment in Iraq which, as U.S. forces withdraw, require evaluation and transfer for reset, use in Af- ghanistan or disposal. We hear that the drawdown is well underway and that over 300,000 containers are moving equipment out each month. General, what is the prospective timeline for retrograde and who is in charge of this effort? Answer. The Commanding General, USARCENT (the Army component of U.S. Central command), is in charge of orchestrating the retrograde of Army materiel from Iraq. He has considerable support from the Army Materiel Command, which has a substantial presence in both Kuwait and Iraq. As directed by the President, the timeline for the drawdown in Iraq is to reduce our military presence to 50,000 U.S. forces by August 31, 2010 and to have all U.S. forces out of Iraq by the end of December 2011. We have developed synchronized and coordinated plans for the drawdown of personnel and for the redistribution and disposition of the equipment and supplies in Iraq. As you noted, that process is well underway. In fact, we are ahead of schedule against the our established monthly targets in every measurable area (e.g., personnel drawdown, vehicles, supplies, base closure, etc.).

QUESTION SUBMITTED BY SENATOR PATRICK J. LEAHY

RECAPITALIZATION Question. As the Army undertakes its recapitalization program, are there any differences in the rates of recapitalization for Army National Guard and Reserve units and the recapitalization of active duty Army units? Can you explain the rationale for the discrepancy if one exists? Answer. The Army recapitalizes equipment based on equipment type, not Army components. There is no difference in recapitalization of equipment between Reserve Components and Active Duty units. 58

QUESTIONS SUBMITTED BY SENATOR PATTY MURRAY

COMPREHENSIVE SOLDIER FITNESS AND MENTAL HEALTH Question. General Casey, I received a brief on Comprehensive Soldier Fitness by General Cornum early last year (February 2009) year and you spoke about it earlier today. This program is a valuable tool for equipping and training our soldiers and family members to maximize their potential and face the physical and psychological challenges of sustained operations. What is the status of this program? Answer. Comprehensive Soldier Fitness (CSF) is a rapidly maturing program designed to develop psychological and physiological resilience across the entire Army community, including soldiers, family members and Department of the Army civilians. To date, over 420,000 soldiers have taken the Global Assessment Tool, which is a web-based strengths assessment. Eight web-based training modules that target resiliency skills are currently available to soldiers once they complete the Global As- sessment Tool, and 20 modules will be available by the end of fiscal year 2010. Ad- ditionally, CSF has trained 829 Master Resilience Trainers at the University of Pennsylvania and satellite locations, with a goal of training at least 1,800 trainers by the end of fiscal year 2010. These Master Resilience Trainers lead resilience development training in their units and local communities. CSF is currently budgeted for $42 million annually over the next 5 years.

MENTAL HEALTH Question. General Casey, your efforts to reduce the stigma of mental health has been worthwhile. I understand that the number of soldiers who feel there is a stigma has been reduced from 80 to 50 percent. However, there is a difference between those who feel there is a stigma versus those who are actually coming forward to seek mental health treatment. Despite the reduced number of soldiers who feel there is a stigma, are more soldiers coming forward to seeking treatment? Answer. Yes, more soldiers are coming forward to seek treatment. Our behavioral health utilization data shows that active duty utilization of behavioral health services has nearly doubled from 2005 to 2009. Question. What actions is the Army taking to continue to reduce the embarrass- ment around seeking mental help and encourage soldiers to seek treatment? Answer. The Army is aggressively working to address perceived stigma and/or fear of negative repercussions associated with seeking behavioral healthcare. We have developed programs not only to help decrease stigma, but to also provide an increased layer of privacy. The Re-Engineering Systems of Primary Care Treatment in the Military is a program designed to decrease stigma by placing these services within primary care facilities. Through this program, any visit a soldier makes to his/her primary care physician for any reason is an opportunity to screen the Soldier for symptoms associated with post-traumatic stress disorder (PTSD) and/or other behavioral health diagnoses. This program is also accessible via the web, where soldiers can self-refer. Services provided are confidential, with the exception of the determination that a Soldier is at risk of harm to self or others. The Soldier Evaluation for Life Fitness program incorporates behavioral health as a routine component of the health readiness process for all soldiers returning to their home stations following deployment. Since every soldier receives a consultation on-site, no one is stigmatized when seen by a behavioral healthcare practitioner. Through the Soldier Evaluation for Life Fitness program, soldiers first complete a computer-based self-assessment. On-site clinicians review the results of the assessments immediately, allowing them to tailor their consultations to meet each soldier’s unique needs. Soldiers can then be evaluated for individual health risks that may range from PTSD and other behavioral health diagnoses to physical health conditions. Military OneSource is a free information center and website, where soldiers can seek assistance 24 hours/day, 7 days/week. Counseling is provided by phone or in person by Masters-level consultants on issues such as family support, emotional support, debt management, and legal issues at no cost to the soldier for up to 12 sessions. Military OneSource does not release information about users of the services, with the exception of issues of child abuse, elder abuse, spousal abuse, and/ or risk of harm to self or others. Military OneSource can be accessed at www.militaryonesource.com or 1–800–342–9647. Soldiers may complete a free, voluntary online behavioral health self-assessment, and obtain referrals at www.MilitaryMentalHealth.org. This is an approach to assist soldiers and family members with identifying symptoms and getting assistance. It 59 provides confidential and immediate feedback, as well as referrals to TRICARE, Vet- erans Administration Centers, and Military OneSource. Military and Family Life Consultants are also available to assist soldiers who are experiencing difficulty coping. Military and family life consultants are licensed clinical social workers, professional counselors, marriage and family therapists, and psychologists. They provide six free informal and confidential counseling sessions. No records are kept, and flexible appointment times and locations are offered. Sol- diers may access military and family life consultants through the Army Community Services by self referral, without having to provide a reason for seeking these services, or via Military OneSource, which can assist Families with the identification of consultants in the local area. Question. Does your plan include the mental health of families, and if so what is that plan? Answer. The Army is committed to the Army Family Covenant, which recognizes the strong commitment and many sacrifices that families make. The Army also knows that the strength of soldiers is largely dependent upon the strength of their families. To address the behavioral health needs of families, the Army supports many deployment-related programs. For example, two well-developed programs include the Exceptional Family Member Program, which focuses on assistance for families with special needs; and the Family Advocacy Program, which strengthens family relationships and provides assistance and referral to victims of domestic violence and sexual assault. The Army also supports the Military and Family Life Consultant Program (MFLC), which provides deployment-related problem-solving consultation services for families and children in schools on post and in the local community. The Army has instituted Soldier and Family Assistance Centers (SFAC) at all the Warrior Transition Units. The SFAC is a soldier and family-friendly environment that has become a popular location for Warriors in Transition and their Families. The Center provides individualized, integrated support services. To augment the Military Treatment Facility’s behavioral healthcare services, the Army Medical Command recently established the Child, Adolescent and Family Be- havioral Health Proponency (CAF–BHP) at Joint Base Lewis McChord, Tacoma, Washington. This new Proponency specifically addresses family behavioral health needs; its mission is to support and sustain a comprehensive, integrated, behavioral health system of care for military children and their families. The CAF–BHP collaborates with national subject matter experts and professional organizations, including the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and American Psychological Association, to develop and promote evidence-based behavioral health treatments for military children and their families. The CAF–BHP focuses on two new innovative clinical programs, the School Behavioral Health (SBH) and Child and Family Assistance Center (CAFAC). CAFACs are being developed and deployed to help mitigate traditional stove piping of behavioral health services. The CAFAC will provide adult and child family members with 24/7 telephone triage and to mental health services at a single location. Services include psychiatric, psychological, social services and community resourcing. This integrated, comprehensive behavioral healthcare delivery system promotes military readiness, wellness, and resilience in Army children and Fami- lies. Schofield Barracks has an established CAFAC and we are pursuing initiatives at JBLM and Fort Carson. In the next couple of years, we expect to establish the program at Fort Hood, Fort Bragg, Fort Bliss, Fort Campbell, Fort Sill, and Fort Drum. To promote evidence-based treatments and best practices, the CAF–BHP trains primary care providers and their staff in screening, diagnosing and treating common behavioral health concerns. The CAF–BHP also designs marketing strategies to decrease the stigma associated with seeking behavioral healthcare.

STRYKER V HULLS Question. General Casey, as you well know, three Stryker brigades from Fort Lewis Washington are on deployment today. Two are in Iraq and another in Afghan- istan. It is my understanding the Army has gone to great lengths to enhance the safety of these troops by adding armor kits to the vehicles to defeat various threats. It is also my understanding that a so-called double-V hull—something similar to the MRAP vehicle—has been developed for the Stryker to further increase the protection of our soldiers. Can you explain the utility of the double-V hull and if this is something we should be doing to protect those brave Stryker brigade soldiers? Answer. The Double V-hull enhancement shows great potential for increasing survivability and mitigating the blast effects of Improvised Explosive Devices. The Dou- 60 ble V-hull is an accelerated portion of the current Army acquisition strategy for Stryker modernization. The Double-V shaped hull will potentially provide Mine Re- sistant Ambush Protected vehicle-like protection to a proven fighting vehicle in the Army’s most highly demanded Brigade Combat Team. If testing proves successful, the Army anticipates fielding an initial capability of Double V-hulled Strykers in late fiscal year 2011, with a complete brigade set (minus Mobile Gun System and Nuclear Biological Chemical Reconnaissance Vehi- cle) to Operation Enduring Freedom by late fiscal year 2012.

QUESTIONS SUBMITTED BY SENATOR THAD COCHRAN

RESTORING BALANCE/RISK Question. General Casey, over the past few years, we have heard about efforts to restore balance to the Army. In your prepared testimony, restoring balance is discussed, and it is noted that the Army lacks sufficient strategic flexibility and continues to accumulate risk to meet the challenges you may face in the future. Can you expand on this statement and explain what it means, and over time, how much risk has accumulated and is now being accepted by the Army. Does the Army and our Armed Forces find themselves in the same situation as the proverbial frog in a pot of water—the frog is cozy as the water slowly heats-up and doesn’t recognize the danger it is in? Answer. The Army’s forces are committed to prevailing in the current fight by ramping up in Afghanistan as we responsibly draw down in Iraq. Thanks to the support of Congress and the American people, the Army is receiving the resources it needs to restore readiness, but the continuing pace of operations means we are consuming that readiness as fast as we produce it. The commitment of the Army to Iraq and Afghanistan limits the choices available to our national leadership if another crisis—whether humanitarian or armed conflict—arises. It also means the Army cannot train all units to standard on full spectrum operations, which is necessary to provide a trained and ready force for the variety of possible missions in a world of persistent conflict. We are making progress in restoring balance, reaching a sustainable and predictable force rotational cycle in 2012 of 2 years at home station for every year deployed for our Active Component, and 4 years at home station for every year mobilized for our Reserve Component. However, even after the end of major combat operations in Afghanistan, we expect a few challenging years of recapitalizing and repairing equipment, re-integrating with our families, and training forces for full spectrum operations, before we can provide true strategic flexibility to our leaders. With Congress’ continued support, the Army will restore balance by achieving sustainable deploy-to-dwell ratios; adequately providing for soldiers, civilians, and families; and with reliable, timely, and consistent funding, resetting our equipment and pre-positioned stocks. These measures will restore readiness and the strategic flexibility necessary to provide trained and ready forces for full spectrum operations and future contingencies at a tempo that is predictable and sustainable for our All-Vol- unteer Force.

ARMY UNMANNED AERIAL VEHICLES Question. General Casey, I am informed that the Army plans to modify the Shad- ow Unmanned Aerial Vehicle to meet requirements that the terminated Fire Scout program was expected to fulfill. The fiscal year 2011 budget request includes over a half billion to begin this work. General Casey, can you share with the Committee the thought behind the Fire Scout termination, and will this $500 million investment in Shadow provide your soldiers with the full capability needed to conduct their missions? Answer. With the termination of Future Combat Systems, we determined that the Fire Scout did not fulfill a requirement in the modular Brigade Combat Teams (BCT). The improvements that we are making to our Shadow fleet will sufficiently address the most critical capability gaps in the BCTs. Some of these improvements include retrofit kits to increase endurance while adding reliability, laser designation capability and NSA Type I encryption. Our BCTs, Fires Brigades, Battlefield Sur- veillance Brigades and Special Forces formations will benefit from the additional capabilities funded in the fiscal year 2011 President’s budget. This improvement effort will continue beyond fiscal year 2011 to provide full capability to our soldiers. 61

RESILIENCY OF THE FORCE Question. General Casey, does the fiscal year 2011 budget continue to fully support Army Resiliency initiatives? What other efforts are included in this year’s budget which was not part of the fiscal year 2010 program? Answer. Yes. Comprehensive Soldier Fitness is fully funded in fiscal year 2011 at $42.5 million. Future efforts include expanding the Master Resilience Trainers (MRT) program by establishing an MRT course at Fort Jackson, South Carolina; reaching out to family members through voluntary participation in the Global As- sessment Tool; and increasing the online Comprehensive Resilience Modules.

BRIGADE COMBAT TEAM (BCT) MODERNIZATION Question. General Casey, over $20 billion has been invested in technologies developed under the terminated Future Combat System program. The Army now plans to field some of these technologies to Army brigades under the Brigade Combat Team Modernization program. What systems or technologies are going to be fielded under this effort, and how have they performed in recent testing? Answer. Increment 1 of Brigade Combat Team (BCT) Modernization contains systems from the FCS program. It provides enhanced war fighter capabilities to the Current Force in two primary areas. First, it provides enhanced situational awareness, force protection and lethality through the use of unattended and attended sensors and munitions. Second, it provides a communications network backbone for In- fantry BCT and Battalion Command Networks. Increment 1 capabilities consist of the following systems: Unattended Urban and Tactical Ground Sensors, Small Un- manned Ground Vehicle, Class I Block 0 Unmanned Air Vehicle, Non Line of Sight- Launch System, and Network Integration Kit (for the HMMWV). During the 2009 Limited User Test, Increment 1 capabilities met or partially met 14 of 15 Army test criteria. The systems did not meet reliability criteria. User tests revealed issues with equipment and software reliability, availability and maintainability. The program office, in coordination with the U.S. Army Test and Evaluation command and U.S. Army Training and Doctrine Command, is taking steps to correct these issues. To date, more than 94 percent of the hardware issues have been corrected and the program is continuing to integrate software changes and increased capability in preparation for the 2010 test cycle.

MINE RESISTANT AMBUSH PROTECTED (MRAP) VEHICLES Question. General Casey, when Secretary Gates announced his adjustments to De- fense acquisition programs last year, he terminated the manned ground vehicle portion of the Future Combat System. One of reasons cited for the termination was that the Army’s current vehicle program did not include a role for the Mine Resist- ant Ambush-Protected vehicles which has received more than $30 billion of investment. What is the Army plan for incorporating Mine Resistant Ambush-Protected vehicles across your unit formations? Answer. The Mine Resistant Ambush Protected (MRAP) family of vehicles has performed well in theater and provides critical protection to soldiers against mines and improvised explosive devices. The Army plans to place over 15,000 MRAPs and M–ATVs in the force structure. Vehicles will be allocated to task organized sets, and deployed when MRAP levels of protection are required; used by units to fill existing capability gaps; and used in a robust training fleet to assist soldiers in maintaining proficiency. We will place 9,284 vehicles in the following task organized sets: 11 Infantry Bri- gade Combat Teams; 6 Heavy Brigade Combat Teams, 3 Stryker Brigade Combat Teams and a Multifunctional Support Brigade. The Army is currently analyzing set positioning options. The Army will place 3,631 vehicles on Transportation, Explosive Ordnance Dis- posal and echelon above brigade Medical unit MTOEs. We will also place 1,755 vehicles in training sets around the world and 495 in Sustainment Stocks and War Re- serve. TRADOC will determine allocation of the additional 1,460 MRAP All Terrain Vehicles and 1,300 MRAPs placed on contract in February 2010.

RESET OF ARMY EQUIPMENT Question. General Casey, resetting or recapitalization of Army equipment used in operations the past 8 years is requiring unprecedented funding levels. It’s pointed out in the prepared testimony that resetting Army equipment will need to continue an additional 2 to 3 years after major deployments end. How does the Army plan to maintain equipment reset funding levels and complete this necessary process considering the 5 year budget plan projects only 1 percent annual real growth and an 62 annual Overseas Contingency Operations budget that is more than $100 billion less than it is today? Answer. The Army will continue to request reset funding levels to meet the incremental costs of war in our Overseas Contingency Operations (OCO) budget. Since 2001, Congress has fully funded the reset of Army equipment returning from contingency operations and the Army used these funds to reset units for full spectrum operations. Reset funding for fiscal year 2010 and fiscal year 2011 is adequate to complete the reset of 25 brigades this year, 31 brigades in fiscal year 2011 and represents approximately $11 billion per year. Current funding ensures that equipment can be rapidly repaired or replaced to meet operational requirements. We will continue to use our Reset Cost Model to forecast future reset costs based on force structure and equipping scenarios. Endur- ing requirements that are no longer part of the OCO will transition to our base budgets. This approach, with corresponding budget request adjustments, will align with the 5-year budget plan projections and OCO budget. If OCO Reset needs are not resourced in the year required, it would cause either the deferral of requirements or impact other programs resulting in equipment not being reset (repaired or replaced). The net result would be less reliable equipment or equipment shortages that would impact readiness and potentially put soldiers at risk. Equipment Reset and the associated funding is essential to maintaining equipment readiness and restoring balance to the Army. In partnership with Congress, the Army will continue to identify equipping Reset requirements that are cost effective, timely, and ensure readiness for future operations.

QUESTIONS SUBMITTED BY SENATOR CHRISTOPHER S. BOND

MODERNIZE THE FORCE Question. Tell me about the Army’s plan to modernize the force and what this means for soldiers in the next 2–3 years, specifically regarding the ‘‘spin-outs’’ and the priority delivery plan for the Army Infantry Brigades and others. Were any specific ‘‘spin-outs’’ cut as a result of the changes to Future Combat Systems (FCS)? Answer. After cancellation of the Future Combat Systems (FCS) program, the Army transitioned to a Brigade Combat Team (BCT) Modernization Plan. The Army now refers to ‘‘spin-outs’’ as ‘‘capability packages.’’ This plan is supported by comprehensive lessons learned from more than 8 years of war, focuses on the evolving needs of our warfighters in a rapidly changing security environment and exploits the knowledge and technologies developed under the FCS program. The BCT Modernization Plan aligns the fielding of capabilities with the Army Force Generation Model, so that soldiers will have the right capabilities at the right time to accomplish their mission. In the next 3 years, the Army plans to field the first increment to three Infantry Brigade Combat Teams (IBCTs). We anticipate fielding the first brigade set of Increment 1 equipment in 2011 and two additional sets in 2012. Rather than making one modernization decision and applying it over two or more decades (as typically done in the past), the BCT Modernization Plan recognizes that modernization decisions must be made incrementally to stay ahead of the demands of the security environment and the needs of our warfighters. After the program’s cancellation, we reevaluated FCS systems in light of our evolving needs. This led to the cancellation of the Class IV Unmanned Air System, the Multifunction Utility/Logistics and Equipment Transport (MULE–T) and the MULE-Countermine (MULE–CM) unmanned ground vehicles. Our analysis concluded that the Class IV UAS was no longer a cost-effective solution because current UAS, with some improvements, can sufficiently meet most requirements. Likewise, the two large robots (MULE–T and MULE–CM) did not meet rapidly changing threats or address critical future mission needs. Question. What is the Army’s plan to integrate the Guard into its modernization efforts with respect to a proportional and concurrent delivery of the equipment needed to modernize? Answer. Because the Army has operationalized the Reserve Components to support Combatant Commanders, the Active Component (AC) is no longer a major factor in determining the order in which we field modernized systems. The goal of this strategy, which is based on the Army Force Generation Model, is to provide units with the equipment they need to perform their next mission. The Army’s equipping strategy provides the most modern, capable equipment to deploying units without regard to whether they are AC, Army National Guard (ARNG), or Army Reserve. Additionally, we remain committed to ensuring ARNG units are equipped to at least 63

80 percent of their critical dual use items (despite significant overseas contingency operations and reset requirements) with a goal of reaching 100 percent. This is designed to ensure ARNG preparedness to support civil support missions. Between September 2008 and September 2010, ARNG equipment on hand percentages will increase by approximately 6 percent, and ARNG equipment modernization levels will increase by approximately 4 percent. Both of these increases surpass the ACs improvements over the same time period. The Army is continuing to invest in ARNG modernization by procuring equipment that will complete ARNG modernization in several key areas over the next year or two. For example, the Army will soon complete the ARNG fielding of Force XXI Bat- tle Command Brigade and Below and the M777 howitzer system. We will also complete 96 percent of the ARNG Warfighter Information Network-Tactical systems. For ARNG aircraft, the Army is working toward modernizing the fleet. The Light Utility Helicopter (LUH) is a key element of this strategy. The Army will field 88 of 210 LUHs by fiscal year 2011. The ARNG has the first two HH–60M equipped Medical Evacuation companies in the Army, as well as the second UH–60M equipped assault battalion. The ongoing modernization of the UH–60A series aircraft (A–A–L) will continue to reduce the number of non-modernized Blackhawks fleetwide in all components. We have already modernized four of the eight ARNG attack battalions with AH–64D model Apaches and plan to convert the remaining four battalions in fiscal year 2013–14. The ARNG is receiving three CH–47F models for its training base, and will begin receiving CH–47Fs for their operational units in fiscal year 2011. Question. If the current rotary wing modernization plan for the Army Guard is any indication of how the effort is going, I am not hopeful. It is my understanding the President requested funding for only 2 upgraded Blackhawk ‘‘M’’ models for the Army Guard in fiscal year 2011? Is that enough? Answer. Yes, two aircraft are sufficient in fiscal year 2011. The two HH–60Ms MEDEVAC aircraft included for the Army Guard in the fiscal year 2011-base budget will be paired with 10 HH–60Ms procured in the fiscal year 2010 base. This will provide enough aircraft to equip one Army Guard 12-ship MEDEVAC Company. This MEDEVAC Company is to be fielded in fiscal year 2011–12 (1 year after the procurement funding), and will bring the ARNG total UH/HH–60Ms to 70 aircraft. The UH–60M is the standard configuration for the Assault and General Support units. The HH–60M is the Medical Evacuation configuration for the MEDEVAC units.

MILITARY CONSTRUCTION Question. The fiscal year 2011 Army budget request for military construction increased by almost $300 million, so our Guard soldiers and their families thank you for that. I have voiced concern in the past that the military construction funding has not kept pace with the essential needs at Guard installations across the country for modernization and replacement of aging facilities. I applaud the increase in funding from $246 million to $374 million to replace the Guard’s aging facilities. In your view, is this amount appropriate to support Army Guard training and readiness requirements? Funding spent on the renovation and creation of new armories across the country spurs economic growth and enhances the Guard’s and the Reserves’ ability to carry out their missions. The benefit of these construction projects are two-fold because they serve as both military readiness spaces and public locations for community gatherings. As you know, training, maintenance and readiness is hampered by inadequate, unsafe and unhealthy facilities. The high level of mission readiness required of Guard soldiers needs to be supported by functional facilities, so I thank you for your support. Answer. The fiscal year 2011 level of funding provides for 48 projects nationwide. At this level of funding, the average age of an Army National Guard (ARNG) Readi- ness Center will increase from 41 to 49 years over the next decade. The current level of funding provides for major renovation of ARNG facilities every 30 years. Ac- cordingly, at this level of funding, the ARNG will continue to be challenged in meeting its readiness requirements.

TRANSIENTS, TRAINEES, HOLDEES AND STUDENTS (TTHS) ACCOUNT Question. The Army National Guard is the only service component that doesn’t have a Transients, Trainees, Holdees and Students (TTHS) Account. As such, units continue to witness taxing instances of personnel and equipment ‘‘cross-leveling’’ when they are mobilized. Would creating such an account decrease some of the pressure placed upon soldiers’ dwell-time and help the force get ‘‘back in balance?’’ 64

Answer. Yes. In fact, the Army is creating an 8,000 slot TTHS account in the ARNG. Although this is a relatively small account, it is a significant step forward. It will allow the ARNG to place non-deployable soldiers in the TTHS account, thereby freeing spaces in units for trained, deployable personnel. The Army Training and Doctrine Command has worked extensively with the ARNG to increase the number of training seats available to Guard soldiers when recruits are available for training. The result has been a much smaller number of untrained soldiers occupying deployable unit positions. Question. Can a TTHS account be implemented without increasing Army Guard end-strength? Answer. Yes. Because of certain force design updates, the Army National Guard (ARNG) Force Structure Allowance is approximately 350,000. The Congressionally mandated end strength of 358,200 personnel provides a deviation of approximately 8,000 soldiers. The ARNG can manage a small 8,000 soldier Trainees, Transients, Holdees and Students account (TTHS) with this deviation. This will allow the ARNG to remove non-deployable soldiers from operational units, as well as to reduce the untrained recruit population in mobilizing formations. Reducing force structure allowance any further, however, would destabilize the readiness of formations, increase the rate of unit rotations overseas, reduce the ARNG’s accessibility to the Active Component and reduce its ability to function as an operational force. Question. Do Army leaders believe the end-strength is adequate in the ARNG? Answer. Yes, the Army Senior Leaders believe the end strength of the ARNG is adequate. Question. Is the ARNG experiencing commensurate, or ‘‘proportionate’’ troop growth as compared to the active-component? Answer. Since 2005, the Army National Guard (ARNG) has done a tremendous job of increasing its end strength within authorized levels. Over the past 3 years, the ARNG has met its accession mission 35 out of 36 months (in September 2009 it achieved a 99.6 percent accession rate), and increased its total end strength by approximately 12,000 (from an End Strength Mission of 346,165 in March 2007 to 358,200 in February 2010). During this period, the total ARNG End Strength remained between 100–103 percent of the End Strength Mission (only in August 2008, did the end strength reach 103.1 percent). In 2006, as part of the Grow the Army Initiative, the ARNG’s end strength authorization grew by 8,200. The current temporary end strength increase in the Ac- tive Army will benefit the Army National Guard by allowing an increased dwell for all Army units.

SUBCOMMITTEE RECESS Chairman INOUYE. This subcommittee will reconvene on Wednes- day, March 10, at 10:30. And at that time, we will consider health programs of DOD. And, with that, the subcommittee stands in recess. [Whereupon, at 10:35 a.m., Wednesday, March 3, the subcommittee was recessed, to reconvene at 10:30 a.m., Wednesday, March 10.] DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, MARCH 10, 2010

U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10:13 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) presiding. Present: Senators Inouye, Murray, and Cochran. DEPARTMENT OF DEFENSE

MEDICAL HEALTH PROGRAMS

STATEMENT OF VICE ADMIRAL ADAM M. ROBINSON, JR., SURGEON GENERAL, DEPARTMENT OF THE NAVY

OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. The hearing will come to order. This morning, we will review the Department of Defense’s medical programs. And we’ll have two panels. First, we’ll hear from the Surgeon Generals of the services: General Schoomaker, Admiral Adam Rob- inson, Jr., and General Charles Green. Then we’ll hear from the Chiefs of the Nurse’s Corps, General Patricia Horoho, Admiral Karen Flaherty, and General Kimberly Siniscalchi. And I’d like to welcome all of you this morning, and I’d like to welcome back General Schoomaker, Admiral Robinson, and a special welcome to General Green, when he gets here. Welcome, sir. General GREEN. Thank you. My apologies. Chairman INOUYE. This is your first hearing, and we look forward to working together. The subcommittee holds a special hearing each year for an opportunity to discuss the critically important issues related to healthcare, the well-being of our servicemembers and their families. As such, the Surgeons General and the Chiefs of the Nurse’s Corps have been called upon to share their insight on areas that need improvement and areas that see continuing success and progress. Military medicine is a critical element in our defense strength and an essential component of the benefits provided to our servicemembers and their families. We must ensure that the most (65) 66 advanced treatment and technology is being used by expertly trained personnel, and, on the battlefield, at the same time, providing sufficient capacity to care for servicemembers and their families at home. Our ability to care for our wounded on the modern battlefields is a testament both to hard work and dedication of our men and women in uniform and to the application of new technology, which is a hallmark of the United States Armed Forces. It is also due to the dedicated men and women in our Medical Service Corps that are deploying with our soldiers, airmen, sailors, and marines. On average, over 50 percent of our current Active Duty Medical Service Corps have deployed at least once. Numerous specialties have had multiple deployments. This tempo is making it more challenging to recruit and to retain qualified medical personnel into the services, and is presenting new stress for our caregivers who move from treating injured servicemembers on the battlefield to treating them back at home. We are concerned about the number of deployments for all servicemembers, but today I’d like to take this opportunity to highlight the impact on our medical personnel. Our medical personnel rely on a small pool of resources for deployment. While the total medical workforce is over 255,000, many of these individuals are civilians or contractors, and do not deploy. Therefore, the total pool of deployable military medical personnel is only 177,000 plus. In 2009, 12,700 medical personnel were deployed, over 7 percent of the pool. These numbers present serious challenges to the men and women testifying before us. It falls on them to ensure a proper balance of care at home and treatment on the battlefield, all the while furthering our advances in training and technology, and providing care for our caregivers. To help meet these needs, our medical service personnel must be provided sufficient resources. The fiscal year 2011 budget before us goes a long way in providing these resources. The Department has made substantial progress in moving programs into the base budget that were initially funded through supplementals. Determining that medical research and prevention for injuries such as traumatic brain injury (TBI), psychological health, prosthetic, eye injuries, and hearing loss, and so much more, our co- budget responsibility of the Department of Defense (DOD) is essential in addressing the numerous issues facing our families and members. In addition, we’re aware that resources are required to achieve a world-class facility at the new Walter Reed National Military Medical Center. We also understand that more will be required as we continue to identify the long-term needs of both our wounded and our nonwounded servicemembers and their families. These are some of the issues we’ll discuss this morning, and I look forward to your testimony and note that your full statements will be made part of the record. And may I call upon you, Admiral Robinson, for the opening statement. SUMMARY STATEMENT OF VICE ADMIRAL ADAM M. ROBINSON, JR. Admiral ROBINSON. Thank you very much, sir. 67 Good morning, Chairman Inouye, Senator Cochran, Senator Mur- ray, distinguished members of the subcommittee. I want to thank you for your unwavering support of Navy medicine—particularly as we continue to care for those who go in harm’s way—their families, and all beneficiaries. I am honored to be with you today to provide an update on the state of Navy medicine, including some of our accomplishments, our challenges and our strategic priorities. Navy medicine: world-class care anytime, anywhere. This poignant phrase is arguably the most telling description of Navy medicine’s accomplishments in 2009 and continues to drive our operational tempo and priorities for the coming years and beyond. Throughout the last year, we saw challenges and opportunities and, moving forward, I anticipate the pace of operations and demands will continue to increase. We have been stretched in our ability to meet our increasing operational and humanitarian assistance requirements, as well as maintain our commitment to provide care to a growing number of beneficiaries. However, I am proud to say that we are responding to this demand with more flexibility and agility than ever before. The foundation of Navy medicine is force health protection; it’s what we do and why we exist. Nowhere is our commitment more evident than in Iraq and Afghanistan. During my October 2009 trip to theater, I again saw the outstanding work of our medical personnel. The Navy medicine team is working side by side with Army and Air Force medical personnel and coalition forces to deliver outstanding healthcare to our troops and civilians alike. As our wounded warriors return from combat and begin the healing process, they deserve a seamless and comprehensive approach to their recovery. We want them to mend in body, mind, and spirit. Our patient and family centered approach brings together medical treatment providers, social workers, case managers, behavioral health providers, and chaplains. We are working closely with our line counterparts with the Marine Corps Wounded Warrior regiments and Navy’s Safe Harbor, to support the full-spectrum recovery process for sailors, marines, and their families. We must act with a sense of urgency to continue to help build resiliency among our sailors and marines, as well as the caregivers who support them. We are aggressively working to reduce the stigma surrounding psychological health and operational stress concerns which can be a significant barrier to seeking mental health services. Programs such as Navy operational stress control, Marine Corps combat operational stress control, FOCUS—that is, families over coming under stress—caregiver occupational stress control, and our suicide prevention programs are in place and maturing to provide support to personnel and their families. An important focus area for all of us continues to be caring for our warriors suffering with traumatic brain injury. We are expanding TBI training to healthcare providers throughout the fleet and the Marine Corps. We are also implementing a new in-theater TBI Surveillance Program and conducting important research. We are also employing a strategy that is both collaborative and integrative by actively partnering with the other services, the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury, 68 the Department of Veterans Affairs, and leading academic medical and research centers, to make the best care available to our warriors. We must continue to recognize the occupational stress on our caregivers. They are subject to the psychological demands of exposure to trauma, loss, fatigue, and inner conflict. This is why our caregiver occupational stress control programs are so important to building and sustaining the resiliency of our providers. Mental health specialists are being placed in operational environments and forward deployed to provide services where and when they are needed. The Marine Corps is sending more mental health teams to the front lines, with the goal of better treating an emotionally strained force. Operational stress control and readiness teams, known as OSCAR, will soon be expanded to include the battalion level. This will put mental health support services much closer to combat troops. A mobile care team of Navy medicine mental health professionals is currently deployed to Afghanistan, conducting mental health surveillance, commander leadership consultation, and coordination of mental healthcare for sailors throughout the area of responsibility (AOR). As you know, an integral part of Navy medicine, or Navy’s maritime strategy is humanitarian assistance and disaster relief. In support of Operation Unified Response, Haiti, Navy medicine answered the call. We deployed Comfort from her home port in Balti- more, within 77 hours of the order, and ahead of schedule. She was on station in Port-au-Prince, 5 days later. And from the beginning, the operational tempo onboard Comfort was high, and our personnel have been challenged, both professionally and personally. For many, this will, indeed, be a career-defining experience. And I spoke to the crew as they were preparing to get underway, and related just how important this mission is and why it is a vital part of Navy’s maritime strategy. I am encouraged with our recruiting efforts within Navy medicine, and we are starting to see the results of new incentive programs. But, while overall manning levels for both officer and enlisted personnel are relatively high, ensuring we have the proper specialty mix continues to be a challenge in both the Active and Reserve components. Several wartime critical specialties, as well as advanced practice nursing and physicians assistants, are undermanned. We are facing shortfalls for general dentists, oral maxillofacial surgeons, and many of our mental health specialists, including clinical psychologists and social workers. We continue to work hard to meet this demand, but fulfilling the requirements among these specialties is expected to present a continuing challenge. Research and development is critical to Navy medicine’s success and our ability to remain agile to meet the evolving needs of our warfighter. It is where we find solutions to our most challenging problems and, at the same time, provide some of medicine’s most significant innovations and discoveries. Research efforts targeted at wound management, including enhanced wound repair and reconstruction, as well as extremity and 69 internal hemorrhage control and phantom limb pain in amputees, present definitive benefits. These efforts support our emerging expeditionary medical operations and aid in support to our wounded warriors. Clearly, one of the most important priorities for leadership of all the services is the successful transition to the Walter Reed Na- tional Military Medical Center on board the campus at the Na- tional Naval Medical Center. We are working diligently with the lead DOD organizations, the Joint Task Force National Capital Medical, to ensure that this significant and ambitious project is executed without any disruption to services to our sailors, marines, and their families, and all of our beneficiaries for whom we are privileged and honored to serve. In summary, I believe that we are at an important crossroads for military medicine. How we respond to the challenges facing us today will likely set the stage for decades to come. Commitment to our wounded warriors and their families must never waiver, and our programs of support and hope must be built and sustained for the long haul. And the long haul is the rest of this century, when the young wounded warriors of today mature into our aging heroes in the latter part of this century. They will need our care and support, as well as their families, for a lifetime. PREPARED STATEMENT On behalf of the men and women of Navy medicine, I want to thank the subcommittee for their tremendous support, their confidence and their leadership. It has been my pleasure to testify today, and I look forward to your questions. Thank you very much. [The statement follows:]

PREPARED STATEMENT OF VICE ADMIRAL ADAM M. ROBINSON, JR.

INTRODUCTION Chairman Inouye, Senator Cochran, distinguished Members of the Subcommittee, I am honored to be with you today to provide an update on the state of Navy Medi- cine, including some of our accomplishments, challenges and strategic priorities. I want to thank the Committee Members for your unwavering support of Navy Medi- cine, particularly as we continue to care for those who go in harm’s way, their families and all beneficiaries. Navy Medicine—World Class Care...Anytime, Anywhere. This poignant phrase is arguably the most telling description of Navy Medicine’s accomplishments in 2009 and continues to drive our operational tempo and priorities for the coming year and beyond. Throughout the last year we saw challenges and opportunities; and moving forward, I anticipate the pace of operations and demands placed upon us will continue to increase. Make no mistake: We have been stretched in our ability to meet our increasing operational and humanitarian assistance requirements, as well as maintain our commitment to provide Patient and Family-Centered care to a growing number of beneficiaries. However, I am proud to say to that we are responding to this demand with more flexibility and agility than ever before. We are a vibrant, world-wide healthcare system fully engaged and integrated in carrying out the core capabilities of the Maritime Strategy around the globe. Regardless of the challenges ahead, I am confident that we are well-positioned for the future. Since becoming the Navy Surgeon General in 2007, I have invested heavily in our strategic planning process. How we accomplish our mission is rooted in sound planning, sharp execution and constructive self-assessment at all levels of our organization. I challenged our leadership to create momentum and establish a solid foundation of measurable progress. It’s paying dividends. We are seeing improved and sustained performance in our strategic objectives. Just as importantly, our planning 70 process supports alignment with the Department of Navy’s Strategic Plan and Oper- ations Guidance. Navy Medicine’s commitment to Patient and Family-Centered Care is also reflected in our resourcing processes. An integral component of our Strategic Plan is providing performance incentives that promote quality and directly link back to workload and resources. We are evolving from a fiscal planning and execution process rooted in historical data, to a system which links requirements, resources and performance goals. This transformation properly aligns authority, accountability and financial responsibility with the delivery of quality, cost-effective healthcare. The President’s budget for fiscal year 2011 adequately funds Navy Medicine to meet its medical mission for the Navy and Marine Corps. The budget also provides for the maintenance of our facilities. We are, however, closely assessing the resource impacts associated with Operation Unified Response, in Haiti. While seeking reimbursement as appropriate from U.S. Southern Command in accordance with DOD direction, we are working to mitigate any potential impacts—both in the short-term and long-term. We are cross-leveling personnel, meaning that we are assigning personnel within Navy Medicine to ensure effective use of existing resources, while leveraging support from the Navy Reserve, the other Services and our civilian network partners, as needed, and when conditions warrant.

FORCE HEALTH PROTECTION The foundation of Navy Medicine is Force Health Protection. It’s what we do and why we exist. In executing our Force Health Protection mission, the men and women of Navy Medicine are engaged in all aspects of expeditionary medical operations in support of our warfighters. The continuum of care we provide includes all dimensions of physical and psychological well-being. This is our center of gravity and we have and will continue to ensure our Sailors and Marines are medically and mentally prepared to meet their world-wide missions. Nowhere is our commitment to Force Health Protection more evident than in our active engagement in military operations in Iraq and Afghanistan. As these overseas contingency operations evolve, and in many respects become increasingly more dangerous, we are seeing burgeoning demand for expeditionary combat casualty care in support of joint operations. I recently returned from a trip to Afghanistan and I again saw the outstanding work of our medical personnel. The Navy Medicine team is working side-by-side with Army and Air Force medical personnel and coalition forces to deliver outstanding healthcare to our troops and civilians alike. We must continue to be innovative and responsive at the deckplates and on the battlefield. Since the start of Operation Enduring Freedom and Operation Iraqi Freedom, the Marine Corps has fielded new combat casualty care capabilities which include: updated individual first aid kits with combat gauze, advanced tourniquets, use of Tactical Combat Casualty Care principles, troop training in Combat Life- saver, and the use of Factor VII—a blood clotting agent used in trauma settings. In addition, Navy Fleet Hospital transformation has redesigned expeditionary medical facilities that are lighter, modular, more mobile, and interoperable with other Services’ facilities. Our progress is also evident in the innovative work undertaken by a Shock Trau- ma Platoon (STP) 2 years ago in Afghanistan. This team, comprised of two physicians, two nurses, a physician assistant and 14 corpsmen, essentially created a mobile emergency room—a seven-ton truck with a Conex container and welded steel plates—that went into combat to administer more expedient and effective care in austere settings. This prototype led to the creation of the Mobile Trauma Bay (MTB), a capability that both Marine Corps and Navy Medicine leadership immediately recognized as vital to the warfighter and an unquestionable life-saver on the battlefield. MTB use has already been incorporated into our Afghanistan shock trauma platoon operations, and they are already positively impacting forward resuscitative and stabilization care. We understand that the Marine Corps has fully embraced the MTB concept and is planning to add additional units in future POM submissions.

HUMANITARIAN ASSISTANCE AND DISASTER RESPONSE An integral part of the Navy’s Maritime Strategy is humanitarian assistance and disaster response. In the wake of the devastating earthquake in Haiti earlier this year, our Nation moved forward with one of the largest relief efforts in our history to save lives, deliver critically needed supplies and provide much-needed hope. The response was rapid, as Navy deployed ships and expeditionary forces, comprised of more than 10,000 personnel, to provide immediate relief and support for the Haitian people. In support of Operation Unified Response, Navy Medicine answered the call. 71

We deployed USNS Comfort (T–AH 20) from her homeport in Baltimore within 77 hours and ahead of schedule—going from an industrial shipboard site to a ready afloat Naval hospital, fully staffed and equipped. She was on station in Port-au- Prince 5 days later and treating patients right away. From the beginning, the operational tempo onboard USNS Comfort has been high with a significant trauma and surgical caseload. Medical teams from the ship are also ashore to help in casualty evaluation, triage crush wounds, burn injuries and other health issues. Providing care around the clock, our personnel have been challenged both professionally and personally. For many, this will be a career-defining experience and certainly reflects the Navy’s commitment as a ‘‘Global Force for Good.’’ I spoke to the crew as they were preparing to get underway, and personally related just how important this mission is and why it is a vital part of the Navy’s Maritime Strategy. We train so we are mission ready and USNS Comfort was well-prepared for this challenging deployment as a result of her crew’s participation in Continuing Prom- ise (April–June 2009), a humanitarian and civic assistance mission, in partnership with nations of the Caribbean and Latin America, to provide medical, dental, veterinary, educational and engineering programs both ashore and afloat. We are continuing to respond to requirements from the Commander, U.S. South- ern Command in order to put the proper supporting medical elements in the area of operations. Navy Medicine additional support includes the deployment of a For- ward Deployed Preventive Medicine Unit (FDPMU) and augmented Casualty Re- ceiving and Treatment Ship (CRTS) medical staff capabilities onboard U.S.S. Ba- taan (LHD 5). We also recognize the potential psychological health impact on our medical personnel involved in this humanitarian assistance mission and have ensured we have trained Caregiver Occupational Stress Control (CgOSC) staff onboard. Navy Medicine is inherently flexible and capable of meeting the call to support multiple missions. I am proud of the manner in which the men and women of Navy Medicine leaned forward in response to the call for help. In support of coordination efforts led by the Department of State and the U.S. Agency for International Devel- opment, and in collaboration with nongovernmental organizations, both domestic and international, our response demonstrated how the expeditionary character of our Naval and Marine forces is uniquely suited to provide assistance during interagency and multinational efforts.

CONCEPT OF CARE Navy Medicine’s Concept of Care is Patient and Family-Centered Care. It is at the epicenter of everything we do. This concept is elegant in its simplicity yet extraordinarily powerful. It identifies each patient as a participant in his or her own healthcare and recognizes the vital importance of the family, military culture and the military chain of command in supporting our patients. My goal is for this Con- cept of Care—this commitment to our patients and their families—to resonate throughout our system and guide all our actions. It is enabled by our primary mission to deliver force health protection and a fully ready force; mutually supported by the force multipliers of world class research and development, and medical education. It also leverages our emphasis on the health and wellness of our patients through an active focus on population health.

CARING FOR OUR HEROES When our Warriors go into harm’s way, we in Navy Medicine go with them. At sea or on the ground, Sailors and Marines know that the men and women of Navy Medicine are by their side ready to care for them. There is a bond of trust that has been earned over years of service together, and make no mistake, today that bond is stronger than ever. Our mission is to care for our wounded, ill and injured, as well as their families. That’s our job and it is our honor to have this opportunity. As our Wounded Warriors return from combat and begin the healing process, they deserve a seamless and comprehensive approach to their recovery. We want them to mend in body, mind and spirit. Our focus is multidisciplinary-based care, bringing together medical treatment providers, social workers, case managers, behavioral health providers and chaplains. We are working closely with our line counterparts with programs like the Marine Corps’ Wounded Warrior Regiments and the Navy’s Safe Harbor to support the full-spectrum recovery process for Sailors, Marines and their families. Based on the types of injuries that we see returning from war, Navy Medicine continues to adapt our capabilities to best treat these conditions. When we saw a need on the West Coast to provide expanded care for returning Wounded Warriors with amputations, we established the Comprehensive Combat and Complex Cas- 72 ualty Care (C5) Program at Naval Medical Center, San Diego, in 2007. C5 manages severely injured or ill patients from medical evacuation through inpatient care, outpatient rehabilitation, and their eventual return to active duty or transition from the military. We are now working to expand utilization of Project C.A.R.E—Com- prehensive Aesthetic Recovery Effort. This initiative follows the C5 model by ensuring a multidisciplinary approach to care, yet focuses on providing state-of-the-art plastic and reconstructive surgery for our Wounded Warriors at both Naval Medical Center San Diego and Naval Medical Center Portsmouth, with potential future opportunities at other treatment facilities. We have also significantly refocused our efforts in the important area of clinical case management at our military treatment facilities and major clinics serving Wounded Warriors to ensure appropriate case management services are available to all who need them. The Clinical Case Management Program assists patients and families with clinical and non-clinical needs, facilitating communication between patient, family and multi-disciplinary care team. Our clinical case managers collaborate with Navy and Marine Corps Recovery Care Coordinators, Federal Recovery Coordinators, Non-Medical Care Managers and other stakeholders to address Sailor and Marine issues in developing Recovery Care Plans. As of January 2010, 192 Clin- ical Case Managers are assigned to Military Treatment Facilities and ambulatory care clinics caring for over 2,900 Sailors, Marines and Coast Guardsmen.

PSYCHOLOGICAL HEALTH AND POST-TRAUMATIC STRESS We must act with a sense of urgency to help build resiliency among our Sailors and Marines, as well as the caregivers who support them. We recognize that operational tempo, including the number and length of deployments, has the potential to impact the psychological health of service members and their family members. We are aggressively working to reduce the stigma surrounding psychological health and operational stress concerns which can be a significant barrier to seeking mental health services for both military personnel and civilians. Programs such as Navy Operational Stress Control, Marine Corps Combat Operational Stress Control, FOCUS (Families Overcoming Under Stress), Caregiver Occupational Stress Control (CgOSC), and our suicide prevention programs (A–C–T Ask-Treat-Care) are in place and maturing to provide support to personnel and their families. The Navy Operational Stress Control program and Marine Corps Combat Oper- ational Stress Control program are the cornerstones of the Department of the Navy’s approach to early detection of stress injuries in Sailors and Marines and are comprised of: —Line led programs which focus on leadership’s role in monitoring the health of their people. —Tools leaders may employ when Sailors and Marines are experiencing mild to moderate symptoms. —Multidisciplinary expertise (medical, chaplains and other support services) for more affected members. Decreasing the stigma associated with seeking psychological healthcare requires a culture change throughout the Navy and Marine Corps. Confronting an ingrained culture will take time and active leadership support. Stigma reducing interventions span three major fronts: (1) education and training for individual Sailors and Ma- rines that normalizes mental healthcare; (2) leadership training to improve command climate support for seeking mental healthcare; and (3) encouragement of care outreach to individual Sailors, Marines, and their commands. This past year saw wide-spread dissemination of Operational Stress Control (OSC) doctrine as well as a Navy-wide education and training program that includes mandatory Navy Knowl- edge Online courses, instructor led and web-based training. Navy Medicine ensures a continuum of psychological healthcare is available to service members throughout the deployment cycle—pre-deployment, during deployment, and post-deployment. We are working to improve screening and surveillance using instruments such as the Behavior Health Needs Assessment Survey (BHNAS) and Post-Deployment Health Assessment (PDHA) and Post-Deployment Health Re- assessment (PDHRA). Our mental health specialists are being placed in operational environments and forward deployed to provide services where and when they are needed. The Marine Corps is sending more mental health teams to the front lines with the goal of better treating an emotionally strained force. Operational Stress Control and Readiness (OSCAR) teams will soon be expanded to include the battalion level, putting mental health support services much closer to combat troops. A Mobile Care Team (MCT) of Navy Medicine mental health professionals is currently deployed to Afghanistan to conduct mental health surveillance, command leadership consultation, and coordi- 73 nate mental healthcare for Sailors throughout the AOR. In addition to collecting important near real-time surveillance data, the MCT is furthering our efforts to decrease stigma and build resilience. We are also making mental health services available to family members who may be affected by the psychological consequences of combat and deployment through our efforts with Project FOCUS, our military treatment facilities and our TRICARE network partners. Project FOCUS continues to be successful and we are encouraged that both the Army and Air Force are considering implementing this program. We also recognize the importance of the counseling and support services provided through the Fleet and Family Support Centers and Marine Corps Community Serv- ices. Beginning in 2007, Navy Medicine established Deployment Health Centers (DHCs) as non-stigmatizing portals of care for service members staffed with primary care and psychological health providers. We now have 17 DHCs operational. Our healthcare delivery model supports early recognition and treatment of deployment- related psychological health issues within the primary care setting. Psychological health services account for approximately 30 percent of all DHC encounters. We have also increased mental health training in primary care, and have actively partnered with Line leaders and the Chaplain Corps to develop combat and operational stress control training resources. Awareness and training are keys to our surveillance efforts. Over 4,000 Navy Medicine providers, mental health professionals, chaplains and support personnel have been trained to detect, screen and refer personnel who may be struggling with mental health issues. We must continue to recognize the occupational stress on our caregivers. They are subject to the psychological demands of exposure to trauma, loss, fatigue and inner conflict. This is why our Caregiver Occupational Stress Control programs are so important to building and sustaining the resiliency of our providers. We cannot overlook the impact on these professionals and I have directed Navy Medicine leadership to be particularly attuned to this issue within their commands.

TRAUMATIC BRAIN INJURY While there are many significant injury patterns in theatre, an important focus area for all of us remains Traumatic Brain Injury (TBI). Blast is the signature injury of OEF and OIF—and from blast injury comes TBI. The majority of TBI injuries are categorized as mild, or in other words, a concussion. Yet, there is much we do not yet know about these injuries and their long-term impacts on the lives of our service members. The relative lack of knowledge about mild TBI amongst service members and healthcare personnel represents an important gap that Navy Medicine is seriously addressing. We are providing TBI training to healthcare providers from multiple disciplines throughout the fleet and the Marine Corps. This training is designed to educate personnel about TBI, introduce the Military Acute Concussion Exam (MACE) as a screening tool for mild TBI, inform providers about the Automated Neurocognitive Assessment Metric (ANAM) test, and identify a follow-up for assessment including use of a repeatable test battery for identification of cognitive status. We have recently established and are now expanding our TBI program office to manage the implementation of the ANAM as a pre-deployment test for service members in accordance with DOD policy. This office will further develop models of assessment and care as well as support research and evaluation programs. All the Services expect to begin implementation of a new in-theater TBI surveillance system which will be based upon incident event tracking. Promulgated guidelines will mandate medical evaluation for all service members exposed within a set radius of an explosive blast, with the goal to identify any service member with subtle cognitive deficits who may not be able to return to duty immediately. Navy Medicine has begun implementing the ANAM assessment at the DHCs and within deploying units as part of an Assistant Secretary of Defense (Health Affairs) mandate. We have also partnered with Line leadership, or operational commanders, to identify populations at risk for brain injury (e.g., front line units, SEAL units, and Navy Explosive Ordinance Disposal units). In addition, an in-theater clinical trial for the treatment of vestibular symptoms of blast-exposure/TBI was completed at the USMC mTBI Center in Al Taqqadum, Iraq. Both our Naval Health Research Center and Navy-Marine Corps Public Health Center are engaged with tracking TBI data through ongoing epidemiology programs. Goals this year include the establishment of a restoration center in-theatre to allow injured Sailors and Marines a chance to recover near their units and return to the fight. 74

Additionally, the National Naval Medical Center’s Traumatic Stress and Brain In- jury Program provides care to all blast-exposed or head-injured casualties returning from theatre to include patients with an actual brain injury and traumatic stress. Navy Medicine currently has TBI clinics at San Diego, Portsmouth, Camp Pendleton and Camp Lejeune with plans for further expansion reflecting our commitment to the treatment of this increasingly prevalent injury. We are employing a strategy that is both collaborative and integrative by actively partnering with the other Services, Defense Center of Excellence for Psychological Health and Traumatic Brain Injury, the Veterans Administration, and leading academic medical and research centers to make the best care available to our Warriors afflicted with TBI.

EXCELLENCE IN RESEARCH AND DEVELOPMENT (R&D) Research and development is critical to Navy Medicine’s success and our ability to remain agile to meet the evolving needs of our warfighters. It is where we find solutions to our most challenging problems and, at the same time, provide some of medicine’s most significant innovations and discoveries. Our R&D programs are truly force-multipliers and enable us to provide world-class healthcare to our beneficiaries. The approach at our research centers and laboratories around the world is straightforward: Conduct health and medical research, development, testing, evaluation and surveillance to enhance deployment readiness. Each year, we see more accomplishments which have a direct impact on improving force health protection. The contributions are many and varied, ranging from our confirmatory work in the early stages of the H1N1 pandemic, to the exciting progress in the development of a malaria vaccine. Research efforts targeted at wound management, including enhanced wound repair and reconstruction as well as extremity and internal hemorrhage control, and phantom limb pain in amputees, present definitive benefits. These efforts also support our emerging expeditionary medical operations and aid in support to our Wounded Warriors.

THE NAVY MEDICINE TEAM Navy Medicine is comprised of compassionate and talented professionals who continue to make significant contributions and personal sacrifices to our global community. Our team includes our officers, enlisted personnel, government civilian employees, contract workers and volunteers working together in a vibrant healthcare community. All have a vital role in the success of our enterprise. Our priority is to maintain the right workforce to deliver the required medical capabilities across the enterprise, while using the appropriate mix of accession, retention, education and training incentives. Overall, I am encouraged with our recruiting efforts within Navy Medicine and we are starting to see the results of new incentive programs. But while overall manning levels for both officer and enlisted personnel are relatively high, ensuring we have the proper specialty mix continues to be a challenge. Several wartime critical specialties including psychiatry, family medicine, general surgery, emergency medicine, critical care and perioperative nursing, as well as advanced practice nursing and physician assistants, are undermanned. We are also facing shortfalls for general dentists, oral maxillofacial surgeons, and many of our mental health specialists including clinical psychologists and social workers. We have increasing requirements for mental health professionals as well as for Reserve Component Medical Corps, Dental Corps, Medical Service Corps and Nurse Corps officers. We continue to work hard to meet this demand, but fulfilling the requirements among these specialties is expected to present a continuing challenge. I want to also reemphasize the priority we place on diversity. We are setting the standard for building a diverse, robust, innovative healthcare workforce, but we can do more in this important area. Navy Medicine is stronger and more effective as a result of our diversity at all levels. Our people are our most important resource, and their dignity and worth are maintained through an atmosphere of service, professionalism, trust and respect.

PARTNERSHIPS AND COLLABORATION Navy Medicine continues to focus on improving interoperability with the Army, Air Force, Veterans Administration (VA), as well other Federal and civilian partners to bring operational efficiencies, optimal technology and training together in support of our patients and their families, our missions, and the national interests. Never has this collaborative approach been more important, particularly as we improve our approaches to ensuring seamless transitions for our veterans. 75

We remain committed to resource sharing agreements with the VA and our joint efforts in support of improving the Disability Evaluation System (DES) through the ongoing pilot program at several MTFs. The goal of this pilot is to improve the disability evaluation process for service members and help simplify their transitions. Together with the VA and the other Services, we are examining opportunities to expand this pilot to additional military treatment facilities. Additionally, in partnership with the VA, we will be opening the James A. Lovell Federal Health Care Cen- ter in Great Lakes, Illinois—a uniquely integrated Navy/VA medical facility. We also look forward to leveraging our inter-service education and training capabilities with the opening of the Medical Education and Training Campus (METC) in San Antonio in 2010. This new tri-service command will oversee the largest consolidation of service training in DOD history. I am committed to an inter-service education and training system that optimizes the assets and capabilities of all DOD healthcare practitioners yet maintains the unique skills and capabilities that our hospital corpsmen bring to the Navy and Marine Corps—in hospitals, clinics at sea and on the battlefield. Clearly one of the most important priorities for the leadership of all the Services is the successful transition to the Walter Reed National Military Medical Center onboard the campus of the National Naval Medical Center, Bethesda. We are working diligently with the lead DOD organization, Joint Task Force—National Capital Re- gion Medical, to ensure that this significant and ambitious project is executed properly and without any disruption of services to our Sailors, Marines, their families, and all our beneficiaries for whom we are privileged to serve.

THE WAY FORWARD I believe we are at an important crossroads for military medicine. How we respond to the challenges facing us today will likely set the stage for decades to come. Commitment to our Wounded Warriors and their families must never waver and our programs of support and hope must be built and sustained for the long-haul—and the long-haul is the rest of this century when the young Wounded Warriors of today mature into our aging heroes in the years to come. They will need our care and support as will their families for a lifetime. Likewise, our missions of cooperative engagement, through humanitarian assistance and disaster response, bring opportunities for us, our military and the Nation. It is indeed a critical time in which to demonstrate that the United States Navy is truly a ‘‘Global Force for Good.’’ Navy Medicine is a vibrant, world-wide healthcare system comprised of compassionate and talented professionals who are willing to make contributions and personal sacrifices. This team—our team—including officer, enlisted, civilians, contractors, and volunteers work together as a dynamic healthcare family. We are all essential to success. Navy Medicine will continue to meet the challenges ahead and perform our missions with outstanding skill and commitment. On behalf of the men and women of Navy Medicine, I want to thank the Committee for your tremendous support, confidence and leadership. It has been my pleasure to testify before you today and I look forward to your questions. Chairman INOUYE. I thank you very much, Admiral. Before we proceed, I must apologize to my vice chairman for overlooking his presence. May I call upon the vice chairman for his opening statement. Senator COCHRAN. Mr. Chairman, thank you very much. It’s a pleasure to join you in welcoming the leaders of our doctors and nurses who serve in the military forces. We appreciate their sacrifice and their service and their leadership in helping ensure that, here at home and around the world, our servicemen and women get the best medical care available. We look forward to working with you in the appropriations process to identify priorities, to make sure that we have money where the needs are, and living up to the commitment that we all feel toward our servicemembers and their families who sacrifice so much for the security interests of our country. Thank you very much for your service and for your presence here today. 76

Chairman INOUYE. Senator Murray. Senator MURRAY. Mr. Chairman, I will pass on an opening statement. I just want to thank all of our witnesses today, and for having this important hearing. Chairman INOUYE. Thank you. Thank you very much. And I’d like to now call upon the Surgeon General of the Army, General Schoomaker. STATEMENT OF LIEUTENANT GENERAL ERIC B. SCHOOMAKER, M.D., Ph.D., SURGEON GENERAL; AND COMMANDER, U.S. ARMY MED- ICAL COMMAND, DEPARTMENT OF THE ARMY General SCHOOMAKER. Chairman Inouye, Vice Chairman Coch- ran, Senator Murray, and other distinguished members of the De- fense Subcommittee, thank you for inviting us here to discuss the Defense Health Program and our respective service medical programs. Now, in my third congressional hearing cycle as the Army Sur- geon General and the Commanding General of the Army Medical Command, I can tell you that these hearings are valuable opportunities for me to talk about the accomplishments and challenges of Army medicine, and to hear—for all of us to hear your collective perspectives regarding military health promotion and healthcare. You and your staff members ask some difficult questions, but these questions help keep us focused on those whom we serve: our soldiers, sailors, airmen, marines, coast guardsmen, our family members, our retirees, and the American public at large. Sir, you earlier introduced her, but I wanted to take this opportunity to welcome and introduce my chief of the Army Nurse Corps, returning from a very successful command of the Western Regional Medical Command, headquartered at Fort Lewis, Washington, and covering the western third of the United States, including Alaska, Major General Patty Horoho. I’m pleased to say that she’ll be joining me on my staff as our Deputy Surgeon General, as of the 1st of April, when David Rubenstein leaves a very successful tour to take command of the Army Medical Center and School in San An- tonio, Texas. And so, Patty, welcome, and we’re glad to have you on the staff. I’m pleased to tell you that the President’s budget submission for fiscal year 2011 fully funds the Army Medical Department’s needs. Your support of the President’s proposed budget will be greatly appreciated. One particular area of special interest to this subcommittee is our comprehensive effort to improve warrior care from the point of injury through evacuation and inpatient treatment to rehabilitation and return to duty or to productive citizens’ lives. We, in Army medicine, continue to focus our efforts on our ‘‘warriors in transition,’’ which is the term we apply to our wounded and injured soldiers. And I want to thank the Congress for its unwavering support of this effort. The support of this subcommittee has allowed us to hire additional providers to staff our warrior transition units, the units to which these warriors in transition are assigned, to conduct relevant medical research, and to build even healing campuses across the Army. 77 I’m convinced the Army has made some lasting improvements there. The most important improvement may be the change of mindset from a focus on disability to an emphasis on ability and achievement. Each of these warriors has the opportunity and the resources to create their own future as soldiers or as productive private citizens. I should say, in this forum, sir, lessons which you, yourself, taught us following your own battle injuries in—in World War II, Mr. Chairman. In keeping with our focus on preventing injury and illness, Army leadership is currently engaged in an all-out effort to change the Department of Defense’s culture regarding traumatic brain injury, or TBI, especially the milder form, which we call ‘‘concussion.’’ Our goal is nothing less than a cultural change in the management of soldiers after potential concussive events. Every warrior requires appropriate treatment to minimize concussive injury and to maximize recovery. To achieve this goal, we are educating the force so as to have trained and prepared soldiers, leaders, and medical personnel to provide early recognition, treatment, and tracking of concussive injuries, ultimately designed to protect warrior health. Traumatic brain injury is a disruption of brain function that results from a blow or a jolt to the head or a penetrating head injury. These occur in combat, they occur on our highways, on our training posts, and on sports fields across the Nation. It’s not a phantom condition that is exhibited by a weak servicemember who’s trying to get out of a deployment. A servicemember who’s behaving badly or irregularly may be struggling and needs help, and we feel very strongly that we need to do everything we can to take care of these warriors who need help. Leaders at all levels must ensure that individuals are aware of, and are willing to take advantage of, available treatments and counseling options. Our concern is—and this has been documented in a number of studies that we’ve conducted, including those in the battlefield— that our soldiers and other servicemembers are not coming forward for treatment after the time of an incident. This results in delay in identification, and it compliments the treatment course back here in the United States. We know that early detection leads to early treatment and improved outcomes. However, undiagnosed concussion leads to symptoms affecting operational readiness on the battlefield and the risk of recurrent concussion during the healing period, which can then lead to more long-term permanent brain impairment. An overview of the education program that we’ve worked on here is included in this packet, ‘‘Brain Injury Awareness Toolkit,’’ which we have available for you and your staffs after the hearing. The Army is issuing very direct standards and protocols to Com- manders and healthcare providers in the field, similar to actions taken after aviation incidents. We have automatic grounding and medical assessments which are required for any soldiers that meets specified criteria. The end state of these efforts is that every servicemember sustaining a potential concussion will receive early detection, state-of- the-art treatment, and return-to-duty evaluation, with long-term digital healthcare record tracking of their management. 78 Treatment of mild traumatic brain injury, or concussion, is an emerging science. We feel strongly that the Army is leading the way in implementing these new treatment protocols for the Depart- ment of Defense, and that the Department of Defense and the military health system (MHS) is leading the Nation in this regard. I truly believe that this evidence-based directive approach to concussive management is going to change the military culture regarding head injuries and significantly impact the well-being of the force. In closing, I’m very optimistic about the next 2 years. We have weathered some very serious challenges to the trust that you all have in Army medicine. Logic would not predict that we would be doing as well as we are, and attracting and retaining and career- developing such a talented team of uniformed and civilian medical professionals. However, we continue to do so, year after year, a tribute to all of our Officer Corps and the leadership of our Non- commissioned Officer Corps and our military and civilian workforce. Their continued leadership and dedication are essential for Army medicine to remain strong, for the Army to remain healthy and resilient, and for the Nation to endure. I personally feel very privileged to serve with these men and women in Army medicine, as soldiers, as Americans, and as global citizens. PREPARED STATEMENT We thank you for holding this hearing and for your unwavering support of the military health system and of Army medicine, and I look forward to answering your questions. Thank you, sir. Chairman INOUYE. I thank you very much, General. [The statement follows:]

PREPARED STATEMENT OF LIEUTENANT GENERAL ERIC B. SCHOOMAKER Chairman Inouye, Vice Chairman Cochran, and distinguished members of the De- fense Subcommittee, thank you for inviting us to discuss the Defense Health Pro- gram and our respective Service medical programs. Now in my third Congressional hearing cycle as the Army Surgeon General and Commanding General, U.S. Army Medical Command (MEDCOM), I can tell you that these hearings are valuable opportunities for me to talk about the accomplishments and challenges of Army Medi- cine and to hear your collective perspectives regarding military healthcare. You and your staff members ask some difficult questions, but these questions help keep us focused on those we serve—the Soldiers, Sailors, Marines, Airmen, Coast Guards- men, Family members, and Retirees as well as the American public. I hope you also find these hearings beneficial as you review the President’s budget submission, which this year fully funds the Army Medical Department’s needs, and determine priorities and funding levels for the next fiscal year. The U.S. Army Medical Department is a complex, globally-deployed, and world class team. My command element alone, the MEDCOM, is an $11 billion international health improvement, health protection, emergency response and health services organization staffed by 70,000 dedicated Soldiers, civilians, and contractors. I am in awe at what these selfless servants have done over the past years—their accomplishments have been quietly, effectively, powerfully successful. While we have experienced our share of crises and even tragedies, despite 8 years of continuous armed conflict for which Army Medicine bears a heavy load, every day our Sol- diers and their Families are kept from injuries, illnesses, and combat wounds through our health promotion and prevention efforts; are treated in cutting-edge fashion when prevention fails; and are supported by an extraordinarily talented medical force to include those who serve at the side of the Warrior on the battlefield. We mourn the loss of 26 teammates in the Fort Hood shootings—six dead and 20 wounded—but are inspired by the resolve shown by their units to continue their 79 missions and the exemplary performance of the 467th and 1908th Medical Detach- ments serving in Afghanistan today. One particular area of special interest to this subcommittee is our comprehensive effort to improve warrior care from point of injury through evacuation and inpatient treatment to rehabilitation and return to duty. I am convinced the Army has made some lasting improvements, and I was recently heartened to read the comments of a transitioning Warrior that reinforced these perceptions. She commented: ‘‘As I look back in the past I am able to see with a reflective eye...the people that have helped me fight this battle, mostly my chain of command, who have always stood beside me instead of in front of me. They have gone out of their way to do what was best for me and I cannot say I would be here still if I hadn’t had such wonderful support... This is my story at the WTB and all in all, I just had to make aware to everyone that has helped that I am very grateful and I truly appreciate all of the work you have done for me.’’ There is nothing more gratifying than to care for these wounded, ill, and injured heroes. We in Army Medicine continue to focus our efforts on our Warriors in Tran- sition and I want to thank Congress for your unwavering support. The support of this committee has allowed us to hire additional providers, staff our warrior transition units, conduct relevant medical research, and build healing campuses. In the remainder of my testimony today, I will discuss how we are providing optimal stewardship of the investment the American public and this Committee has made in Army Medicine. We lead and manage Army Medicine through the Kaplan & Norton Balanced Scorecard performance improvement framework that I introduced to you in last year’s testimony. The Scorecard balances missions and resources across a broad array, while ensuring that near-term measures of success are aligned with longer- term, more strategic results. This balancing is depicted on the Scorecard’s Strategy Map, which shows how we marshal our resources, train and develop our people, and focus our internal processes and efforts so as to balance competing goals. Ultimately our means, ways, and ends contribute toward accomplishing our mission and achieving our strategic vision. The five strategic themes that guide our daily efforts are: Maximize Value in Health Services, Provide Global Operational Forces, Build the Team, Balance Innovation with Standardization, and Optimize Communication and Knowledge Management. Although distinct themes, they inevitably overlap and weave themselves through everything we do in Army Medicine. The first strategic theme—Maximize Value in Health Services—is built on the belief that providing high quality, evidence-based services is not only the right for our Soldiers and Families; it results in the most efficient use of resources within the healthcare system, thus delivering value to not only our Patients, but indeed, the Nation. In fact, what we really want to do is move from a healthcare system to a system for health. We have resisted simply inventing a new process, inserting a new diagnostic test or therapeutic option in vacuo or adding more layers of bureaucracy but are truly adding value to the products we deliver, the care we provide, and the training of our people. This requires focusing on the clinical outcome for the patient and the community and maintaining or even reducing the overall resource expenditure needed to achieve this objective. It has occurred through adoption of evidence-based practices and reducing unwarranted practice variation—even ‘‘unwarranted administrative practice variation’’ for the transactional processes in our work. As one example of this, Army Medicine is expanding upon our Performance Based Budget model to link resources to clinical and quality outputs. The Healthcare Effectiveness and Data Information Set (HEDISR) is a tool used by more than 90 percent of America’s health plans (>400 plans) to measure performance on important dimensions of care, namely, the prevention of disease and evidence-based treatments for some of the most common and onerous chronic illnesses. The measures are very specifically defined, thus permitting comparison across health plans. Since 2007, we have been providing financial incentives to our hospitals, clinics and clinicians for superior compliance in key HEDIS measures. Currently, we track nine measures and compare our performance to national benchmarks. Our performance has improved on each measure, in one case by 63 percent. We have demonstrated that these incentives work to change organizational behavior to achieve desired outcomes in our health system. Put quite simply, our beneficiaries, patients and communities are receiving not only better access to care but better care—objectively measured. As the DOD budget and health-/healthcare-related costs come under increasing scrutiny, this element of our strategy will be even more critical for us. As the United States struggles to address improvements in health and healthcare outcomes while stabilizing or reducing costs of our national system of care, we in Army Medicine 80 and the Military Health System will surely keep the goal of maximizing value in our cross-hairs...or we will find our budgets tightening without a way to measure the effects on our patients’ and our communities’ health and well-being. All of these remarkable achievements would be without meaning or importance to our Soldiers, their Families and our patients if we do not provide access and continuity of care, especially within the direct care system of our medical centers, community hospitals, health centers, and clinics. I am looking carefully at my commanders’ leadership and success in ensuring that their medical and dental treatment facilities provide timely access and optimize continuity of care. We have undertaken major initiatives to improve both access and continuity—this is one of the Army Chief of Staff’s and my top priorities. After conducting thorough business case analyses, Army Medicine is expanding product lines in some markets and expanding clinical space in others. At 14 locations, we are establishing Community Based Pri- mary Care Clinics by leasing and operating clinics located in off-post communities that are close to where active duty Families live, work, and go to school. These clinics will provide a patient-centered medical home for Families and will provide a range of benefits: —Improve the readiness of our Army and our Army Family; —Improve access to and continuity of care; —Reduce emergency room visits; —Improve patient satisfaction; —Implement Best Practices and standardization of services; —Increase physical space available in military treatment facilities (MTFs); and —Improve physical and psychological health promotion and prevention. Along with the rest of the Military Health System, Army Medicine is embracing the Patient-Centered Medical Home concept, which is a recommended practice of the National Committee for Quality Assurance and is endorsed by a number of medical associations, several large third-party payers, and many employers and health plans. The Patient-Centered Medical Home improves patient satisfaction through its emphasis on appropriate access, continuity and quality, and effective communication. The goal is simple: consult with one consistent primary care provider-nurse team for all your medical needs. The seven core features of the Medical Home are: —Personal Primary Care Provider (primary care manager/team); —Primary Care Provider Directed Medical Practice (the primary care manager is team leader); —Whole Person Orientation (patient centered, not disease or provider centered); —Care is Coordinated and/or Integrated (across all levels of care); —Quality and Safety (evidenced-based, safe medical care); —Enhanced Access (meets access standards from the patient perspective); and —Payment Reform (incentivizes the development and maintenance of the medical home). I look for 2010 to be the year Army Medicine achieves what we set out to improve 2 years ago in access and continuity, key elements of our covenant with the Army Family, led by our Chief of Staff and Secretary of the Army. Unlike civilian healthcare systems that can focus all of their energy and resources on providing access and continuity of care, the Military Health System has the equally important mission to Provide Global Operational Forces. The partnership between and among the medical and line leadership of Oper- ations Iraqi Freedom and Enduring Freedom, Central Command, Army Forces Com- mand, U.S. Army Reserve Command, National Guard Bureau, Army Medical De- partment Center and School, Medical Research and Materiel Command, Army G3/ 5/7, and others has resulted in a dynamic reconfiguration of the medical formations and tactics, techniques, and procedures required to support the deployed Army, joint and coalition force. Army Medicine has never missed movement and we continue to achieve the highest survivability rate in the history of warfare. Army Medicine leaders have never lost sight of the need to first and foremost make a difference on the battlefield. This will not change—it will even intensify in 2010 as the complexity of the missions in Afghanistan increases. And this is occurring even while the need to sustain an Army and joint force which is responsibly withdrawing from Iraq puts more pressure on those medics continuing to provide force health protection and care in Oper- ation Iraqi Freedom. This pressure on our All-Volunteer Army is unprecedented. Healthcare providers, in particular, are subject to unique strains and stressors while serving in garrison as well as in deployed settings. The MEDCOM has initiated a defined program to address provider fatigue with current efforts focused on sustaining the healthy force and identifying and supporting higher risk groups. MEDCOM has a healthy healthcare workforce as demonstrated by statistically significant lower provider fatigue and burnout than: The Professional Quality of Life 81

Scale (ProQol) norming sample of 1,187 respondents; and Sprang, Clark and White- Woosley’s study of 222 civilian behavioral health (BH) providers. But as our Chief of Staff of the Army has told us: this is not an area where we just want to be a little better than the other guy—we want the healthiest and most resilient healthcare provider workforce possible. The Provider Resiliency Training (PRT) Program was originally designed in 2006, based on Mental Health Advisory Team findings. The U.S. Army Medical Depart- ment Center and School (AMEDDC&S) developed a military-specific model identifying ‘‘provider fatigue’’ as the military equivalent of compassion fatigue. In June of 2008, MEDCOM implemented a mandated PRT program to educate and train all MTF personnel to include support staff on the prevention and treatment of signs and symptoms of provider fatigue. The stated goal of PRT is to mitigate the negative effects of exposure to combat, to deployment, to secondary trauma from caring for the casualties of war as well as the unremitting demand for healthcare services and from burnout. All will ultimately improve organizational effectiveness. The AMEDDC&S currently offers three courses in support of the MEDCOM PRT: the Train the Trainer Course; the Professional Resiliency Resident Course; and the PRT Mobile Training. None of our goals and themes would be achievable without the right mix of talented professionals within Army Medicine and working with Army Medicine; what our Balanced Scorecard refers to as Build The Team: a larger, more inclusive joint medical team; an adaptive and responsive interagency team (VA, DHS, DHHS/NIH/ NIAID, CDC, USDA, etc.); an effective coalition team; and a military-civilian/academic-operational team. The teams we build must be aligned with the Army, De- fense, and National Military Strategy and long-term goals, not based solely on per- sonalities and the arcane interests of a few. My Deputy Surgeon General, subordinate leaders, and others have been increasingly more deliberate and disciplined in how we form and sustain these critical partnerships. Effective joint, interagency and coalition team-building has been a serious challenge for some time now. I see the emphasis on our ability to craft these teams grow in 2010. The arrival of September 15, 2011—the deadline for the 2005 BRAC—will be one of the key milestones and tests of this skill. My regional commanding generals in San Antonio and Washington, DC have taken lead roles in this endeavor. Let there be no question among those who underestimate our collective commitment to working as a team and our shared vision to serve the Nation and protect and care for the Warriors and his or her Family—we are One Team! In addition to building external teams, we need to have the right mix and quality of personnel internal to Army Medicine. In fiscal year 2010 and continuing into fiscal year 2011 the Army requested funding for programs to improve our ability to attract and retain the professional workforce necessary to care for our Army. Our use of civilian hiring incentives (Recruiting, Retention, and Relocation) increased in fiscal year 2010 by $90 million and should increase by an additional $30 million in fiscal year 2011. In fiscal year 2011, civilian hiring incentives will equate to 4.8 percent of total civilian pay. We have instituted and funded civilian recruiting programs at the MEDCOM, regional, and some local levels to seek qualified healthcare professionals. For our military workforce, we are continuing our successful special salary rates, civilian nurse loan repayment programs, and civilian education training programs. Additionally, our Health Professional Scholarship Program and loan repayments will increase in fiscal year 2010 by $26 million and continue into fiscal year 2011. This program supports 1,890 scholarships and 600 participants in loan repayments—it is as healthy a program as it has ever been. Let me point out that our ability to educate and train from within the force—through physician, nursing, administrative, medic and other programs in professional education—is a vital capability which we cannot permit to be degraded or lost altogether. In addition to providing essential enculturation for a military healthcare provider, administrator and leader, these programs have proven to be critical for our retention of these professionals who are willing to remain in uniform, to deploy in harm’s way and to assume many onerous duties and assignments in exchange for education in some of the Nation’s best programs. Army and Military Graduate Medical, Dental, Nursing and other professional education has undoubtedly played a major role in our remaining a viable force this far into these difficult conflicts. The theme of evidence-based practice runs through everything we do in Army Medicine and is highlighted throughout our Balanced Scorecard. Evidence-based practices mean integrating individual clinical expertise with the best available external clinical evidence from systematic research. Typical examples of evidence- based practices include implementation of clinical practice guidelines and dissemination of best practices. I encourage my commanders and subordinate leaders to be innovative, but across Army Medicine we Balance Innovation with Standardization 82 so that all of our patients are receiving the best care and treatment available. Standardization efforts include: —The MEDCOM AHLTA Provider Satisfaction (MAPS) initiative. —Care of combat casualties through the Joint Theater Trauma System (JTTS), enabled by the use of a Joint Theater Trauma Registry (JTTR)—both of which I will discuss further below—which examines every casualty’s care and outcome of that care, including en route care during medical evacuation (MEDEVAC) with an eye toward standardizing care around the best practices. —The Virtual Behavioral Health Pilot (aka Comprehensive Behavioral Health In- tegration) being conducted at Schofield Barracks and Fort Richardson. —Our initiative to reduce Ventilator Associated Pneumonia events in our ICUs by adopting not only industry best practices, but sending out an expert team of MEDCOM professionals to evaluate our own best practices and barriers to success. —Our standardized events-driven identification and management of mild TBI/concussion on the battlefield coupled with early diagnosis and treatment of Post- Traumatic Stress Reactions/Acute Stress Reactions as close in time and space to the events which lead to these reactions. Programs which are in the process of maturing into best practices for more widespread dissemination are: —The Confidential Alcohol Treatment & Education Pilot (CATEP). —The standardized and now automated Comprehensive Transition Plan for War- riors In Transition in our WTUs and CBWTUs. —A standardized program to ‘‘build trust in Army Medicine’’ through hospitality and patient/client/customer service in our medical, dental, and veterinary treatment facilities and throughout the MEDCOM. —Standardized support of our Active, National Guard, and Reserve forces engaged in the reiterative, cyclic process of the Army Force Generation Model (ARFORGEN) including but not restricted to preparation for combat medics and medical units, Soldier Readiness Processing of deploying units, ensuring full medical readiness of the force, restoration of dental and behavioral health upon redeployment, support of the total Army Family while Soldiers are deployed, and provision of healthcare for mobilized and demobilizing Reserve Component Soldiers and their Families. These and many other standardized efforts reflect a change in how we do the business of Army Medicine. We can no longer pride ourselves on engaging in a mul- tiplicity of local ‘‘science projects’’ being conducted in a seemingly random manner by well-meaning and creative people but without a focus on added value, standard measures of improved outcomes, and sustainability of the product or process. Even the remarkably agile response to the behavioral health needs-assessment and ongoing requirements at Fort Hood following the tragic shooting were conducted in a very deliberate and effective fashion which emphasized unity of command and control, alignment of all efforts and marshalling of resources to meet a well-crafted and even exportable community behavioral health plan. The emphasis which Army Medicine leaders have placed on disciplining these innovative measures so as to harvest best practices, subject them to validation at other sites, and rapidly proliferate them across the MEDCOM and Army in a standard fashion has been remarkable. It is the essence of Optimizing Communication and Knowledge Management. Many of our goals, internal processes and enablers, and resource investments are focused on the knowledge hierarchy: collecting data; coalescing it into information over time and space; giving it context to transform it into knowledge; and applying that knowledge with careful outcome measures to achieve wisdom. This phenomenon of guiding clinical management by the emergence of new knowledge is perhaps best represented by Dr. Denis Cortese, former President and Chief Executive Officer of the Mayo Clinic. He laid out this schematic earlier this year after participating in a set of workshops which centered on healthcare reform. We participated to explore how the Federal system of care might contribute to these changes in health improvement and healthcare delivery. What Dr. Cortese depicted is a three-domain ideal representation of healthcare delivery and its drivers. We share this vision of how an ideal system should operate. His notion is that this system of care should focus on optimizing individual health and healthcare needs, leveraging the knowledge domain to drive optimal clinical practices. This transition from the knowledge domain to the care delivery domain now takes 17 years. The clinical practice domain then informs and drives the payer domain to remunerate for effective clinical outcomes. What occurs too often today is what I call ‘‘widget-building’’ or ‘‘turnstile’’ medical care which chases remunera- tion for these encounters—too often independent of whether it is the best treatment 83 aimed at the optimal outcome. To transform from a healthcare system to a system for health, we need to change the social contract. No longer should we be paid for building widgets (number of clinic visits or procedures), rather, we should be paid for preventing illness and promoting healthy lifestyles. And when bad things happen to good people—which severe illness and injury and war continuously challenge us with—we should care for these illnesses, injuries and wounds by the most advanced evidence-based practices available, reducing unwarranted variation in practice whenever possible. Our Military Health System is subtly different in that we have two practice domains—garrison and battlefield. Increasingly, we leverage the clinical domain to provide feedback into the knowledge domain—with the help of the electronic health record—AHLTA—and specialized databases. We do this in real time and all under the umbrella of the regulatory domain which sets and enforces standards. The reengineering of combat trauma care borne of rapid turnaround of new-found, data-driven knowledge to new materiel and doctrinal solutions is one of the premier examples of this concept. The simplest example is our continuous re-evaluation of materials and devices available to Soldiers, combat life savers, combat medics and the trauma team at the point of injury and in initial trauma management and the intellectual framework for their application to rapidly improve outcomes from combat-injured Warriors. After making the first major change in 40 years to the field medical kit—the Im- proved First Aid Kit (IFAK)—we have modified the contents of the kit at least three times since May 2005 based upon ongoing reviews of the effectiveness of the materials and head-to-head comparisons to competing devices or protocols. In like fashion, we have modified protocols for trauma management through active in-theater and total systemic analyses of the clinical outcomes deriving from the use of materials and protocols. The specialized system in this endeavor is a joint and inter-agency trauma system which creates the equivalent of a trauma network available for a major metropolitan area or geographic region in the United States but spread across three continents, 8000 miles end-to-end—the Joint Theater Trauma System (JTTS). Staffed and led by members of the Army, Navy, Marine Corps and Air Force, it is truly a joint process. It is centered on the U.S. Army Institute of Surgical Research in San Antonio, Texas. The specialized database in this effort and an essential element of the JTTS is the Joint Theater Trauma Registry (JTTR)—a near-comprehensive standardized database which has been developed for each casualty as soon as possible in the treatment evacuation chain—usually at level II or III healthcare in theater. One of the most important critical applications of the JTTS and JTTR at present is the ongoing analysis of MEDEVAC times and the casualties being managed during evacuation. This is our effort to minimize the evacuation time for casualty in a highly dispersed force which is subjected in Afghanistan to the ‘‘tyranny of terrain and weather.’’ The decisions about where and how many trauma teams should be placed around the theater of operation as well as where to place MEDEVAC crews and aircraft is a delicate balancing act—one which balances the risk of putting care providers and MEDEVAC crews and helicopters at risk to the enemy and the elements with the risk of loss of life and limb to Warriors whose evacuation may be excessively prolonged. The only way to fully understand these competing risks is to know the outcomes of care and evacuation by injury type across a wide range of MEDEVAC missions. This analysis will help us understand if we still require a ‘‘Golden Hour’’ for every casualty between initial management at the point of injury and arrival at a trauma treatment site (like an Army Forward Surgical Team, the Marine Forward Resuscitative Surgical System or a Combat Support Hospital) or whether we now have a ‘‘Platinum 15 Minutes’’ at the point of injury which extends the Golden Hour. This methodology and these casualty data are being applied to the next higher level of inquiry: how do we prevent injury and death of our combatants from wounds and accidents at the point of potential injury? Can we design improved helmets, goggles, body armor, vehicles and aircraft to prevent serious injuries? These questions are answered not only through the analysis of wound data, both survivable and non- survivable, through the JTTS and data from the virtual autopsy program of the Of- fice of the Armed Forces Medical Examiner, but also by integrating these data with information from the joint operational, intelligence, and materiel communities to enable the development of improved tactics, techniques, and procedures and materiel improvements to protective equipment worn by the Warriors or built into the vehicles or aircraft in which they were riding. This work is performed by the Joint Trau- ma Analysis and Prevention of Injury in Combat program, a component of the DOD Blast Injury Research Program directed by the National Defense Authorization Act for 2006. To date it has been an effective means of improving the protection of War- 84 riors and preventing serious injury and death even as the enemy devises more lethal and adaptive weapons and battlefield tactics, techniques, and procedures. We in Army Medicine are applying these knowledge management tools and approaches to the improvement of health and the delivery of healthcare back home as well. We are coupling these knowledge management processes with a funding strategy which incentivizes our commanders and clinicians to balance productivity—providing episodes of care—with optimal outcome: the right kind of prevention and care. Among our greatest team achievements in 2009 was our effort to better understand how we communicate effectively with our internal and external stakeholders, patients, clients and customers. We adopted a formal plan to align our messages— ultimately all tied to Army goals and those on our Balanced Scorecard. Our creation of a Strategic Communications Directorate to ensure alignment of our key messages, to better understand and use social media, to expedite cross-talk and learning among such diverse groups as the Office of Congressional Liaison, Public Affairs, Protocol, Medical History, the Borden Institute, the AMEDD Regiment and others speaks directly to these efforts. While we are still in the ‘‘advanced crawl/early walk’’ phase of knowledge management, we know from examples such as the Joint Theater Trauma System and the Performance Based Budget Model that we can move best practices and newly found evidence-based approaches into common or widespread use if we aggressively coordinate and manage our efforts and promote transparency of data and information and the knowledge which derives from it. We have begun a formal process under the Strategy and Innovation Directorate to move the best ideas in both clinical and transactional processes into standard practices across the MEDCOM in a timely way. This will be achieved through a process to identify, validate, and transfer best practices. We endeavor to be more agile and adaptive in response to a rapidly changing terrain of U.S. and Federal healthcare and operational requirements for a Nation at war. In closing, I am very optimistic about the next 2 years. We have weathered some serious challenges to trust in Army Medicine. Logic would not predict that we would be doing as well as we are in attracting, retaining and career developing such a talented team of uniformed and civilian medical professionals. However, we continue to do so year after year—a tribute to all our Officer Corps, the leadership of our Non-Commissioned Officers, and our military and civilian workforce. The results of our latest Medical Corps Graduate Medical Education Selection Board and the Human Capital Distribution Plan show continued strength and even improvements over past years. The continued leadership and dedicated service of officers, non-commissioned officers, and civilian employees are essential for Army Medicine to remain strong, for the Army to remain healthy and strong, and for the Nation to endure. I feel very privileged to serve with the men and women of Army Medicine during this historic period as Army Medics, as Soldiers, as Americans and as global citizens. Thank you for holding this hearing and your unwavering support of the Military Health System and Army Medicine. I look forward to working with you and your staff and addressing any of your concerns or questions. Chairman INOUYE. And now may I call upon General Green. STATEMENT OF LIEUTENANT GENERAL (DR.) CHARLES B. GREEN, SURGEON GENERAL, DEPARTMENT OF THE AIR FORCE General GREEN. Chairman Inouye, Vice Chairman Cochran— Thank you, sir. I’m new at this, and please forgive me. Chairman Inouye, Vice Chairman Cochran, and distinguished members of the subcommittee, it’s an honor and a privilege to appear before you representing the Air Force Medical Service. I look forward to working with you, and pledge to do all in my power to support the men and women of our Armed Forces and this great country. Thank you for your immeasurable contributions to the success of our mission. ‘‘Trusted Care Anywhere’’ is our vision for 2010 mission and beyond. Our nearly 60,000 total force medics contribute world-class medical capabilities to Air Force, joint, and coalition teams. Over 1,600 Air Force medics are currently deployed to 40 locations in 20 85 countries, delivering state-of-the-art preventive medicine, rapid life- saving care, and critical-care air evacuation. At home, our healthcare teams assure patient-centered care to produce healthy and resilient airmen and provide families and retirees with full- spectrum healthcare. Our success on the battlefield underscores our ability to provide ‘‘Trusted Care Anywhere.’’ Since 2001, we have air-evacuated more than 70,000 patients from Afghanistan and Iraq. We have lost only four patients, and one dog. Joint and coalition medical teams have achieved a less than 10 percent died of wounds rate, the best survival rate in the history of war. In July, a British soldier sustained multiple gunshot wounds in Afghanistan. He was stabilized by medical teams on the ground, who replaced his blood more than 10 times and removed an injured lung. It took two airplanes, three aircrews to get the medical team and equipment in place, and another aircraft to fly the patient to Germany. Every member of the joint casualty care and air evacuation team selflessly gave their all to ensure this soldier received the critical care and compassionate support required. This was the first known successful air evacuation of a patient with a traumatic lung removal. The patient is doing well in Birmingham, England, today. In January 2010, a U.S. marine sustained dislocation of both knees, with loss of blood flow to his lower legs following an improvised explosive device (IED) attack in the Helmand Province. Cas- ualty evacuation delivered the marine to our British partners at Camp Bastion, where surgeons restored blood flow to both legs, using temporary shunt procedures that our surgeons had shared in surgical journals. The marine was further evacuated to Craig Joint Theater Hospital at Bagram, where Air Force surgeons performed definitive vascular reconstruction. The marine is now recovering at National Naval Medical Center and is expected to have fully functional limbs. These success stories are possible only because of the tireless efforts of Air Force, Army, Navy, and coalition medics to continuously improve our care. Air Force medics are responding globally in humanitarian missions as well as on the battlefield. Over the last 6 months, we contributed significant support in Indonesia, to the treatment and evacuation of Haiti earthquake victims, and now have another expeditionary medical system (EMEDS) that should be arriving in Chile today. The Air Force Special Operations Command had 47 medics on the ground within 12 hours following the Haiti disaster, performing site assessments, preventive public health measures, and delivering lifesaving care. And Air Force EMEDS continues to coordinate care in Haiti today. At home, we’re improving our patient and provider satisfaction through our patient-centered medical home, building strong partnerships between patients and their healthcare teams. We are seeing improved performance in healthcare continuity, in quality, access, and patient satisfaction, based on our medical-home efforts. We recognize the high OPSTEMPO and have identified high-risk groups to target interventions and training, improving both airmen 86 and family resilience. Collaborative care, in the form of mental health providers embedded in our family health clinics is present at the majority of Air Force treatment facilities today. To achieve our vision of ‘‘Trusted Care Anywhere,’’ we require highly trained, current, and qualified providers. We are extremely grateful to this subcommittee for your many efforts to strengthen our recruiting and retention programs. Your support, in particular, for the Health Profession Scholarship Program, the Uniformed Services University, and other retention initiatives is making a huge difference. We are also indebted to private sector and Federal partners, who help us maximize resources, leverage new capabilities, and sustain clinical currency. Our research partners, with universities and private industry, ensure U.S. forces benefit from the latest medical technologies and clinical advancements, and research and regen- erative medicine, directed energy, improved diabetes prevention and treatment, and state-of-the-art medical informatics shapes the future and allows Air Force medics to implementation innovative solutions. Our Centers for the Sustainment of Trauma and Readiness Skills at St. Louis University, University of Maryland, Baltimore Shock Trauma, and University of Cincinnati College of Medicine are all superb examples of what we can achieve through partnerships. We also actively partner with the VA to meet beneficiary needs, and now have five joint ventures, including Keesler Air Force Base, Mississippi, and soon will open our sixth, with the standup at Buckley Air Force Base, Colorado. PREPARED STATEMENT The Air Force Medical Service is committed to the health and wellness of all entrusted to our care. We are, as our Chief says, all in to meet our Nation’s call, and we will achieve our vision through determined, continuous improvement. We could not achieve our goals of better readiness, better health, better care, and best value for our heroes and their families without your support. Thank you, sir. Chairman INOUYE. I thank you very much. [The statement follows:]

PREPARED STATEMENT OF LIEUTENANT GENERAL CHARLES B. GREEN ‘‘Trusted Care Anywhere’’ is the Air Force Medical Service’s vision for 2010 and beyond. In the domain of Air, Space and Cyberspace, our medics contribute to the Air Force, Joint, and coalition team with world class medical capabilities. Our 60,000 high performing Total Force medics around the globe are trained and ready for mission success. Over 1,600 Air Force medics are now deployed to 40 locations in 20 countries, building partnership capability and delivering state of the art preventive medicine, rapid life-saving care, and critical air evacuation. In all cases, these efforts are conducted with joint and coalition partners. At home, our healthcare teams assure patient-centered care to produce healthy and resilient Air- men, and provide our families and retirees with full spectrum healthcare. Today’s focus is on world-class healthcare delivery systems across the full spectrum of our operations. From theater hospitals in Balad and Bagram, to the efforts of humanitarian assistance response teams, to the care of our families at home, we put patients first. We are transforming deployable capabilities, building patient-centered care platforms, and investing in our people, the foundation of our success. We are expanding collaboration with joint and coalition partners to collectively strengthen rapid response capabilities. Globally, Air Force medics are diligently 87 working to balance the complex demands of multiple missions in current and expanding areas of operations. We are committed to advancing capabilities through education and training, research, and infrastructure recapitalization. Recent efforts in these areas have paid huge dividends, establishing new standards in virtually every major category of full spectrum care including humanitarian assistance. The strategic investments assure a trained, current, and deployable medical force today and tomorrow. They reinforce a culture of learning to quickly adapt medical systems and implement agile organizations to produce healthier outcomes in diverse mission areas. While we’ve earned our Nation’s trust with our unique capabilities and the expertise of our people, we constantly seek to do better! I would like to highlight our areas of strategic focus and share some captivating examples of Air Force medics in action.

TRANSFORMING EXPEDITIONARY MEDICINE AND AEROMEDICAL EVACUATION CAPABILITIES Our success on the battlefield underscores our ability to provide ‘‘Trusted Care, Anywhere.’’ The joint and coalition medical teams bring wounded warriors from the battlefield to an operating room within an unprecedented 20 to 40 minutes! This rapid transfer rate enables medics to achieve a less than 10 percent died-of-wounds rate, the best survival rate ever seen in war. In late July, a British soldier sustained multiple gunshot wounds in Afghanistan. After being stabilized by medical teams on the ground, who replaced his blood supply more than 10 times, doctors determined the patient had to be moved to higher levels of care in Germany. It took two airplanes to get the medical team and equipment in place, another aircraft to fly the patient to Germany, three aircrews and many more personnel coordinating on the ground to get this patient to the next level of care. Every member of the joint casualty care and aeromedical evacuation teams selflessly gave their all to ensure this soldier received the compassionate care he deserved. After landing safely at Ramstein Air Base in Germany, the soldier was flown to further medical care at a university hospital by helicopter. This case highlights the dedication and compassion our personnel deliver in the complex but seamless care continuum. This tremendous effort contributes to our unprecedented survival rate. As evidenced in this story, our aeromedical evacuation system (AE) and critical care air transport teams (CCATT) are world-class. We mobilize specially trained flight crews and medical teams on a moment’s notice to transport the most critical patients across oceans. Since November 2001, we have transported more than 70,000 patients from Afghanistan and Iraq. We are proud of our accomplishments to date, but strive for further innovation. As a result of battlefield lessons learned, we have recently implemented a device to improve spinal immobilization for AE patients that maximizes patient comfort and reduces skin pressure. We are working toward an improved detection mechanism for compartment syndrome in trauma patients. The early detection and prevention of excess compartment pressure could eliminate irreversible tissue damage for patients. In February 2010, a joint Air Force and Army team will begin testing equipment packages designed to improve ventilation, oxygen, fluid resuscitation, physiological monitoring, hemodynamic monitoring and intervention in critical care air transport.

INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY Our Theater Medical Information Program Air Force (TMIP AF) is a software suite that automates and integrates clinical care documentation, medical supplies, equipment, and patient movement. It provides the unique capabilities for in-transit visibility and consolidated medical information to improve command and control and allow better preventive surveillance at all Air Force deployed locations. This is a historic first for the TMIP AF program. Critical information is gathered on every patient, then entered into the Air Force Medical Service (AFMS) deployed system. Within 24 hours, records are moved and safely stored at secure consolidated databases in the United States. During the first part of 2010, TMIP AF will be utilized in Aeromedical Evacuation and Air Force Special Operations areas.

EXPEDITIONARY MEDICINE AND HUMANITARIAN ASSISTANCE We have also creatively developed our Humanitarian Assistance Rapid Response Team (HARRT), a Pacific Command (PACOM) initiative, to integrate expeditionary medical systems and support functions. The HARRT provides the PACOM Com- 88 mander with a rapid response package that can deploy in less than 24 hours, requires only two C–17s for transport and can be fully operational within hours of arrival at the disaster site. This unique capability augments host nation efforts during the initial stages of rescue/recovery, thus saving lives, reducing suffering, and preventing the spread of disease. So far, HARRT successfully deployed on two occasions in the Pacific. Efforts are underway to incorporate this humanitarian assistance and disaster relief response capability into all AFMS Expeditionary Medical System (EMEDS) assets. Air Force medics contribute significant support to the treatment and evacuation of Haiti earthquake victims. The Air Force Special Operations Command sent 47 medics to support AFSOC troops on the ground within 12 hours following the disaster to perform site assessments, establish preventive public health measures, and deliver life-saving trauma care to include surgical and critical care support. This team was also instrumental in working with Southern Command and Transpor- tation Command to establish a patient movement bridge evacuating individuals from Haiti via air transport. As part of the U.S. Air Force’s total force effort, we sent our EMEDS platform into Haiti and rapidly established a 10-bed hospital to link the hospital ship to ground operations. The new EMEDS includes capabilities for pediatrics, OB/GYN and mental health. Personnel from five Air Force medical treatment facilities (MTFs) are supporting Operation Unified Response, as well as volunteers from the Air Reserve Forces.

BUILD PATIENT-CENTERED CARE AND FOCUS ON PREVENTION TO OPTIMIZE HEALTH We are committed to achieving the same high level of trust with our patients at home through our medical home concept. Medical home includes initiatives to per- sonalize care, and to improve health and resilience. We are also working hard to optimize our operations, reduce costs and improve patient access. We partner with our Federal and civilian colleagues to continuously improve care to all our beneficiaries. Family Health Initiative To achieve better health outcomes for our patients, we implemented the Family Health Initiative (FHI). FHI mirrors the American Academy of Family Physicians’ ‘‘Patient Centered Medical Home’’ concept and is built on the team-approach for effective care delivery. The partnership between our patients and their healthcare teams is critical to create better health and better care via improved continuity, and reduce per capita cost. Our providers are given full clinical oversight of their care teams and are expected to practice to the full scope of their training. We believe the results will be high quality care and improved professional satisfaction. Two of our pilot sites, Edwards AFB, CA, and Ellsworth AFB, SD, have dramatically improved their national stand- ings in continuity, quality, access to care, and patient satisfaction. Eleven other bases are implementing Medical Home, with an additional 20 bases scheduled to come on-line in 2010. We are particularly encouraged by the results of our patient continuity data in Medical Home. Previous metrics showed our patients only saw their assigned provider approximately 50 percent of the time. At Edwards and Ellsworth AFBs, provider continuity is now in the 80–90 percent range. We still have work to do, such as developing improved decision support tools, case management support, and improved training. Implementing change of this size and scope requires broad commitment. The Air Force Medical Service has the commitment and is confident that by focusing on patient-centered care through Medical Home, we will deliver exceptional care in the years ahead. The Military Health System’s Quadruple Aim of medical readiness, population health, experience of care and per capita cost serves us well. Patient safety remains central to everything we do. By focusing on lessons learned and sharing information, we continually strive to enhance the safety and quality of our care. We share our clinical lessons learned with the Department of Defense (DOD) Patient Safety Cen- ter and sister Services. We integrate clinical scenarios and lessons learned into our simulation training. We securely share de-identified patient safety information across the Services through DOD’s web-based Patient Safety Learning Center to continuously improve safety. Improving Resilience and Safeguarding the Mental Health of Our Airmen Trusted care for our beneficiaries includes improving resilience and safeguarding their mental health and well-being. We are engaged in several initiatives to optimize mental health access and support. 89

Air Force post-deployment health assessment (PDHA) and post-deployment health re-assessment (PDHRA) data indicates a relatively low level of self-reported stress. However, about 20–30 percent of service members returning from OIF/OEF deployments report some form of psychological distress. The number of personnel referred for further evaluation or treatment has increased from 25 percent to 50 percent over the past 4 years, possibly reflecting success in reducing stigma of seeking mental health support. We have identified our high-risk groups and can now provide targeted intervention and training. We recently unveiled ‘‘Defenders Edge,’’ which is tailored to security forces Air- men who are deploying to the most hostile environments. This training is intended to improve Airmen mental resiliency to combat-related stressors. Unlike conventional techniques, which adopt a one-on-one approach focusing on emotional vulnerability, ‘‘DEFED’’ brings the mental health professional into the group environment, assimilating them into the security forces culture as skills are taught. Airmen who are at higher risk for post traumatic stress are closely screened and monitored for psychological concerns post-deployment. If treatment is required, these individuals receive referrals to the appropriate providers. In addition to standard treatment protocols for post traumatic stress disorder (PTSD), Air Force mental health professionals are capitalizing on state-of-the-art treatment options using Vir- tual Reality. The use of a computer-generated virtual Iraq in combination with goggles, headphones, and a scent machine allow service members to receive enhanced prolonged exposure therapy in a safe setting. In January 2009, 32 Air Force Medical Service therapists received Tri-Service training in collaboration with the Defense Center of Excellence at Madigan Army Medical Center. The system was deployed to eight Air Force sites in February 2009 and is assisting service members in the treatment of PTSD. Future applications of technology employing avatars and virtual worlds may have multiple applications. Service member and family resiliency will be enhanced by providing pre- and post-deployment education; new parent support programs may offer virtual parent training; and family advocacy and addiction treatment programs may provide anger management, social skills training, and emotional and behavioral regulation. Rebuilding Our Capabilities by Recapturing Care and Reducing Costs Our patients appropriately expect AFMS facilities and equipment will be state- of-the art and our medical teams clinically current. They trust we will give them the best care possible. We are upgrading our medical facilities and rebuilding our capabilities to give patients more choice and increase provider satisfaction with a more complex case load. In our larger facilities, we launched the Surgical Optimiza- tion Initiative, which includes process improvement evaluations to improve operating room efficiency, enhance surgical teamwork, and eliminate waste and redundancy. This initiative resulted in a 30 percent increase in operative cases at Elmen- dorf AFB, Alaska, and 118 percent increase in neurosurgery at Travis AFB, Cali- fornia. We are engaged in an extensive modernization of Wright-Patterson Air Force Base Medical Center in Ohio with particular focus on surgical care and mental health services. We are continuing investment in a state-of-the-art new medical campus for SAMMC at Lackland AFB, TX. Our ambulatory care center at Andrews AFB, MD, will provide a key capability for the delivery of world-class healthcare in the National Capital Region’s multi-service market. By increasing volume, complexity and diversity of care provided in Air Force hospitals, we make more care available to our patients; and we provide our clinicians with a robust clinical practice to ensure they are prepared for deployed operations, humanitarian assistance, and disaster response. Partnering With Our Private Sector and Federal Partners Now more than ever, collaboration and cooperation with our private sector and Federal partners is key to maximizing resources, leveraging capabilities and sustaining clinical currency. Initiatives to build strong academic partnerships with St. Louis University, Wright State University (Ohio); University of Maryland; Univer- sity of Mississippi; University of Nebraska-Lincoln; University of California-Davis and University of Texas-San Antonio, among others, bolster research and training platforms and ultimately, ensures a pipeline of current, deployable medics to sustain Air Force medicine. Our long history of collaborating with the Veterans Administration (VA) also enhances clinical currency for our providers, saves valuable resources, and provides a more seamless transition for our Airmen as they move from active duty to veteran status. The Air Force currently has five joint ventures with the VA, including the 90 most recent at Keesler AFB, MS. Additional efforts are underway for Buckley AFB, CO, to share space with the Denver VA Medical Center, which is now under construction. The new joint Department of Defense-Veterans Affairs disability evaluation system pilot started at Malcolm Grow Medical Center at Andrews AFB, MD in Novem- ber 2007. It was expanded to include Elmendorf AFB, AK; Travis AFB, CA and Vance AFB, OK; and MacDill AFB, FL, in May 2009. Lessons learned are streamlining and expediting disability recovery and processing, and creating improved treatment, evaluation and delivery of compensation and benefits. The introduction of a single comprehensive medical examination and single-sourced disability rating was instrumental to improving the process and increasing the transparency. Serv- ices now allow members to see proposed VA disability ratings before separation. We continue to work toward advances in the interoperability of the electronic health record. Recent updates allow near real-time data sharing between DOD and Veterans Affairs providers. Malcolm Grow Medical Center, Wright-Patterson Med- ical Center, and David Grant Medical Center are now using this technology, with 12 additional Air Force military treatment facilities slated to come online. New system updates will enhance capabilities to share images, assessment reports, and data. All updates are geared toward producing a virtual lifetime electronic record and a nationwide health information network.

YEAR OF THE AIR FORCE FAMILY This is the ‘‘Year of the Air Force Family,’’ and we are working hand in hand with Air Force personnel and force management to ensure our Exceptional Family Mem- ber Program (EFMP) beneficiaries receive the assistance they need. In September 2009, the Air Force sponsored an Autism Summit where educational, medical, and community support personnel discussed challenges and best practices. In December 2009, the Air Force Medical Service provided all Air Force treatment facilities with an autism tool kit. The kit provided educational information to providers on diagnosis and treatment. Also, Wright-Patterson AFB, OH is partnering with Children’s Hospital of Ohio in a research project to develop a comprehensive registry for autism spectrum disorders, behavioral therapies, and gene mapping. The Air Force actively collaborates with sister Services and the Defense Center of Excellence for Psychological Health and Traumatic Brain injury (DCoE) to offer a variety of programs and services to meet the needs of children of wounded warriors. One recent initiative was the ‘‘Family Connections’’ website with ‘‘Sesame Street’’-themed resources to help children cope with deployments and injured parents. In addition, DOD-funded websites, such as afterdeployment.org, providing specific information and guidance for parents/caregivers to understand and help kids deal with issues related to deployment and its aftermath. Parents and caregivers also consult with their child’s primary care manager, who can help identify issues and refer the child for care when necessary. Other resources available to families include counseling through Military OneSource, Airman and Family Readiness Centers, Chaplains, and Military Family Life Consultants—all of whom may refer the family to seek more formal mental health treatment through consultation with their primary care manager or by contacting a TRICARE mental health provider directly.

INVESTING IN OUR PEOPLE: EDUCATION, TRAINING, AND RESEARCH Increased Focus on Recruiting and Retention Initiatives To gain and hold the trust of our patients, we must have highly trained, current, and qualified providers. To attract those high quality providers in the future, we have numerous efforts underway to improve recruiting and retention. We’ve changed our marketing efforts to better target recruits, such as providing Corps-specific DVDs to recruiters. The Health Profession Scholarship Program remains vital to attracting doctors and dentists, accounting for 75 percent of these two Corps’ accessions. The Air Force International Health Specialist program is another successful program, providing Air Force Medical Service personnel with opportunities to leverage their foreign language and cultural knowledge to effectively execute and lead global health engagements, each designed to build international partnerships and sustainable capacity. The Nursing Enlisted Commissioning Program (NECP) is a terrific opportunity for Airmen. Several Airmen have been accepted to the NECP, completed degrees, and have been commissioned as Second Lieutenant within a year. To quote a recent graduate, 2nd Lt. April C. Barr, ‘‘The NECP was an excellent way for me to finish 91 my degree and gave me an opportunity to fulfill a goal I set as a young Airman...to be commissioned as an Air Force nurse.’’ For our enlisted personnel, targeted Selective Reenlistment Bonuses, combined with continued emphasis on quality of life, generous benefits, and job satisfaction have positively impacted enlisted recruiting and retention efforts. Increasing Synergy to Strengthen GME and Officer/Enlisted Training We foster excellence in clinical, operational, joint and coalition partner roles for all Air Force Medical Service personnel. We are increasing opportunities for advanced education in general dentistry and establishing more formalized, tiered approaches to Medical Corps faculty development. Senior officer and enlisted efforts in the National Capital Region and the San Antonio Military Medical Center are fostering Tri-Service collaboration, enlightening the Services to each others’ capabilities and qualifications, and establishing opportunities to develop and hone readiness skills. The Medical Education and Training Campus (METC) at Fort Sam Houston, Texas, will have a monumental impact on the Department of Defense and all military services. We anticipate a smooth transition with our moves completed by summer 2011. METC will train future enlisted medics to take care of our service members and their families and will establish San Antonio as a medical training center of excellence. Our Centers for the Sustainment of Trauma and Readiness Skills at St. Louis University, University of Maryland-Baltimore Shock Trauma and University of Cin- cinnati College of Medicine remain important and evolving training platforms for our doctors, nurses and medical technicians preparing to deploy. We recently expanded our St. Louis University training program to include pediatric trauma. Trag- ically, this training became necessary, as our deployed medics treat hundreds of children due to war-related violence. Partnerships with the University Hospital Cincinnati and Scottsdale, AZ, trauma hospitals allow the Air Force’s nurse transition programs to provide newly graduated registered nurses 11 weeks of rotations in emergency care, cardiovascular intensive care, burn unit, endoscopy, same-day surgery, and respiratory therapy. These advanced clinical and deployment readiness skills prepare them for success in Air Force hospitals and deployed medical facilities, vital to the care of our patients and joint warfighters. Setting Clear Research Requirements and Integrating Technology Trusted care is not static. To sustain this trust, we must remain agile and adaptive, seeking innovative solutions to shape our future. Our ongoing research in procedures, technology, and equipment will ensure our patients and warfighters always benefit from the latest medical technologies and clinical advancements. Air Force Medical Service vascular surgeons, Lieutenant Colonels Todd Ras- mussen and William ‘‘Darrin’’ Clouse, have completed 17 research papers since 2005 and edited the vascular surgery handbook. On January 10, 2009 a U.S. Marine sustained bilateral posterior knee dislocations with subsequent loss of blood flow to his lower legs following an improvised explosive device attack in the Helmand Province. Casualty evacuation delivered the Marine to our British partners at Camp Bastion, a level II surgical unit within an hour. At Bastion, British surgeons applied knowledge gained from combat casualty care research and restored blood flow to both legs using temporary vascular shunts. Medical evacuation then delivered the casualty to the 455th Expeditionary Medical Group at Bagram. Upon arrival, our surgeons at Bagram performed definitive vascular reconstruction and protected the fragile soft tissue with negative pressure wound therapy. The Marine is currently recovering at the National Military Medical Center in Bethesda and is expected to have functional limbs. In another example, a 21-year-old Airman underwent a rare pancreatic autotransplantation surgery at Walter Reed Army Medical Center (WRAMC) to sal- vage his body’s ability to produce insulin. The airman was shot in the back three times by an insurgent at a remote outpost in Afghanistan. The patient underwent two procedures in Afghanistan to stop the bleeding, was flown to Germany, then to WRAMC. Army surgeons consulted with University of Miami’s Miller School of Med- icine researchers on transplantation experiments. The surgeons decided to attempt a rare autotransplantation surgery to save the remaining pancreas cells. WRAMC Surgeons removed his remaining pancreas cells and flew them over 1,000 miles to the University of Miami Miller School of Medicine. The University of Miami team worked through the night to isolate and preserve the islet cells. The cells were flown back to WRAMC the next day and successfully implanted in the patient. The surgery was a miraculous success, as the cells are producing insulin. 92

These two cases best illustrate the outcome of our collaborations, culture of research, international teamwork, innovation, and excellence. Shaping the Future Today Through Partnerships and Training Under a new partnership with the University of Illinois at Chicago, we are researching directed energy force protection, which focuses on detection, diagnosis and treatment of directed energy devices. We are exploring the discovery of biomarkers related to laser eye injuries, development of films for laser eye protection and the development of a ‘‘tricorder’’ prototype capable of laser detection and biomarker assessment. Additional efforts focus on the use and safety of laser scalpels and the development of a hand-held battery operated laser tool to treat wounds on the battlefield. We continue our 7-year partnership with the University of Pittsburgh Medical Center to develop Type II diabetes prevention and treatment programs for rural and Air Force communities. Successful program efforts in the San Antonio area include the establishment of a Diabetes Center of Excellence, ‘‘Diabetes Day’’ outreach specialty care, and efforts to establish a National Diabetes Model for diabetic care. Another partnership, with the University of Maryland Medical Center and the Center for the Sustainment of Trauma and Readiness Skills (C–STARS) in Balti- more is developing advanced training for Air Force trauma teams. The project goal is to develop a multi-patient trauma simulation capability using high fidelity trauma simulators to challenge trauma teams in rapid assessment, task management, and critical skills necessary for the survival of our wounded warriors. A debriefing model is being developed to assist with after action reviews for trauma team members. Radio frequency technology is contributing to medical process improvements at Keesler AFB, MS. Currently, Keesler AFB is analyzing the use of automatic identification and data capture (AIDC) in AFMS business processes. The AIDC evaluation focuses on four main areas: patient tracking, medication administration, specimen tracking, and asset management. Further system evaluation and data collection is ongoing in 2010 with an expansion of AIDC use in tracking automated data processing equipment.

CONCLUSION As a unique health system, we are committed to success across the spectrum of military operations through rapid deployability and patient-centered care. We are partnering for better outcomes and increasing clinical capacity. We are strengthening our education and training platforms through partnerships and scanning the environment for new research and development opportunities to keep Air Force medicine on the cutting edge. We will enhance our facilities and the quality of healthcare to ensure health and wellness of all entrusted to our care. We do all this with a focus on patient safety and sound fiscal stewardship. We could not achieve our goals of better readiness, better health, better care and reduced cost without your support, and so again, I thank you. In closing, I share a quote from our Air Force Chief of Staff, Gen. Norton A. Schwartz, who said, ‘‘I see evidence every day the Medical Service is ‘All In,’ faithfully executing its mission in the heat of the fight, in direct support of the warfighter, and of families back home as well.’’ I know you would agree that ‘‘All in’’ is the right place to be.

CRITICAL WARFIGHTING-SKILL BONUSES Chairman INOUYE. I have many questions here. I’d like to submit most of them. But, I have a few. This morning, I received a call from a constituent, who said, ‘‘I just saw an ad that provides a bonus of $350,000 to anyone volunteering to serve as a doctor.’’ I have no idea what service or where the ad was, but, General, do you have any idea what this is all about? RECRUITING BONUSES General SCHOOMAKER. No, sir, but I’ll be happy to look into it further. We have a variety of bonus programs to bring medical professionals of a variety of sources—physicians—— 93

Chairman INOUYE. What is the bonus for, say, a surgeon? General SCHOOMAKER. Sir, I’ll have to look into the—— Chairman INOUYE. Oh. General SCHOOMAKER [continuing]. Specifics of it. It’s dependent upon whether we’re looking at loan repayment from earlier training or multiyear signing bonuses by specialty. It’s pretty much shared across the three services. Maybe—I’m sorry, I don’t have the authority to do this—but maybe one of my colleagues would be able to answer. Admiral ROBINSON. Senator Inouye, Mr. Chairman, I think the critical warfighting-skill bonuses are in the, on the order of about $275,000 over a 4-year period. And I may not have all of the numbers right. And then, there are a variety of lesser bonuses that fit into place. So, there’s variable incentive pay, there’s board-certified pay. There is a list of them, and they’re utilized in general surgery, orthopaedic surgery. And the things that are most critical that we are seeing now are mental health specialists, so psychiatrists will also benefit. There’s another level of board—or of bonus pay for clinical psychologists, for social workers, and also for mental health nurse specialists. It’s much less, but there are incentive bonuses that are being utilized. All three services are utilizing—we do it a little differently, but the amounts are approximately the same. So, I do not know anything about a $350,000 bonus. But, again, we can look into that. [The information follows:] No, there is not currently a $350,000 bonus for ‘‘anyone volunteering to serve as a doctor.’’ Navy currently offers a Critical Wartime Skills Accession Bonus (CWSAB) for specific physician and dental specialties. The accession bonus depends on the specialty being accessed. The bonuses range from $220,000 to $400,000. The Navy currently authorizes CWSAB to General Surgery, Orthopedic Surgery, Urology, Family Medicine, Emergency Medicine, Psychiatry, Pulmonology, Diagnostic Radi- ology, Anesthesiology, Preventive Medicine, Oral and Maxillofacial Surgeons, and Comprehensive Dentists. Chairman INOUYE. I thank you very much. General—— General GREEN. Senator, if I may add—— Chairman INOUYE. Yes. General GREEN. I’m sorry, sir. Under current authorities for the multiyear retention bonuses can go as high as $100,000 a year. Although I am not familiar with the ad that you bring to our attention; however, I will say that, as our personnel communities look at accession bonuses, one of the tools they have used is to build an accession bonus that basically gives a lump-sum payment, but then, they don’t necessarily receive that particular multiyear retention pay. So, accession bonuses could go up, technically, by the authorities we have, as high as $400,000, but then they would not receive that same pay while they were on Active Duty. If that helps you, sir. Chairman INOUYE. Oh, thank you. REHABILITATION FOR WOUNDED WARRIORS General Schoomaker, on warriors in transition, is that a rehab program? Because I had the good fortune to be assigned to Percy Jones General Hospital during World War II, and there they had 94 a 10-month program that included everything from how to use your prosthetic appliance, driving, carpentry, electrical work, plumbing, musical instruments, sports, sex, the whole works—dining. And I felt, when I left the hospital, prepared for the world. Do we have any sort of rehab program for our men and women? General SCHOOMAKER. Yes, sir. I mean, the simple answer is, ‘‘absolutely.’’ In fact, I think, in prior conversations you and I have had, you shared with me the experience that you had. And I’m— I, frankly, have taken that on the road, frequently, to talk about rediscovering lessons from prior wars, what we had in World War II through the convalescent hospital that you recovered in at Battle Creek, our Valley Forge Convalescent Hospital during the Vietnam era. These were lessons, quite frankly, that, in the late 1970s and 1980s and 1990s, we forgot. And as we move toward a more strict definition, much like the civilian sector, of inpatient and outpatient medicine, this war and the injuries, both in battle and not, and the illnesses associated with it, have taught us the need to rediscover and to redesign intermediate rehabilitation. And this transition process that we have, that—most recently, my deputy commander—excuse me—my Assistant Surgeon General for Warrior Care and Transition, and the Commander of our War- rior Transition Command, Brigadier General Gary Cheek, a career artilleryman, has worked on—in association and collaboration with our colleagues in the Navy, the Marine Corps, and the Air Force, has developed a comprehensive transition plan—it’s automated now across our 29 warrior transition units—and nine State-based, community-based warrior transition units. And it includes all of the things that you describe, from initial healing to longer-term recovery and rehabilitation, and includes the family, and is tailored to the individual. It has vocational elements to it, educational elements, and always wraps in there the family and the soldier’s interest in either returning to duty or going out into productive citizenship. On average, right now, about 50 percent of our warriors in transition actually return to duty, which is, I think, a substantial reinvestment of our people back into uniform. You know, I think, sir, that we have returned to duty over 140 amputees, as an example of this, and we’ve sent about 40 of them into combat, 3 or 4 of whom have gone back into combat as amputees, having lost their limb not in combat, but in training accidents or in motor vehicle accidents. And so, we see this as a terrific success and a rediscovery and a recharging of the whole effort to transition these soldiers successfully. Chairman INOUYE. Is this a standard program for all men and women in transition, or is it up to the hospital? WALTER REED NATIONAL MILITARY MEDICAL CENTER General SCHOOMAKER. No, sir. There are criteria to get them into the program. We currently have approximately 9,000 soldiers in them across these units I described; about 7,000 of them are within our hospitals and on campuses in our installations; about 2,000 are out in nine different States in these community-based organizations. We have some fairly good criteria to get them into the program, but, once into the program, the emphasis is in transition. It’s a—an aspirational model that focuses on building abilities and re- 95 channeling or redirecting their efforts and their interests if their former service and their former roles cannot be re-realized again. And it’s in very close association with the Veterans Administration and other civilian rehabilitation efforts. Chairman INOUYE. Thank you. Admiral Robinson, I’d like to ask a few questions relating to Wal- ter Reed National Military Medical Center. The subcommittee has just a vague idea of what the additional budget will look like. We have no idea precisely as to how much military construction will be involved, when will it commence, and how much operation/maintenance will cost, how much new equipment. Can you give us some idea? Admiral ROBINSON. Yes, sir. I can’t give you the complete answer that you’re looking for, but I can give you a Navy answer, of sorts. The complete answer has to be contained in the JTF CAPMED comprehensive master plan for the facility. And then, when that occurs, we can have, I think, an understanding of what requirements will be necessary for the facilities—whatever increased additional cost there will be for facilities at the Walter Reed National Military Medical Center. As I sit today, there is a very—I call, a nonrobust number of about, perhaps, $750 or $800 million that is being projected to be needed in order to finish that construction, but I think that we’ll really need to wait, because that’s not a very good requirements- based analysis, as I sit now. So, I think the first answer is the research—or, the comprehensive master plan. The second portion is, in terms of the building that is occurring now, the Base Realignment and Closure Commission (BRAC) has funded us completely for new construction, and that’s been fine, and that’s worked well. BRAC, as you know, did not fund any renovation. And the problems that have occurred have been that we’re building a wonderful and state-of-the-art facility, but we’re attaching it to a 1982 constructed building. It’s a very good building, it’s a very fine building; but it’s 2010, so it’s a building from another era. The renovation that is going to occur was not part of the BRAC funding, so Navy has taken that up, and we are working hard and will fund the renovation. Sequencing it and getting it all done is the major element now, because we don’t think that we will be able to get all of the renovation done by the opening date of September 2011 at the Walter Reed National Military Medical Center. We do not feel that that will decrease the timeline on the opening of the new medical center, but we do think that there will be more work to be done on the renovation side of the building. And the third thing is, there are many definitions that are now running around regarding what makes the proper facilities commitment and what makes the proper ‘‘world-class’’—which is the word I’m getting to—there are many definitions of what that could be, and I’m not sure exactly what that means. In terms of quality of care, in terms of satisfaction with care, in terms of ability to give care comprehensively, we already feel that we are at a world-class level. If ‘‘world-class’’ is defined from a facilities point of view, that means square footage of operating rooms 96 or square footage of single-family or single-patient rooms, then there will be more work that has to be done. I think that that definition of ‘‘world-class’’ needs to be placed in a very careful place, because ‘‘world-class’’ at the National Naval Medical Center or Walter Reed National Military Medical Center will automatically be translated to ‘‘world-class’’ in the military health system for Army, for Air Force, for Navy, and that will be CONUS and OCONUS facilities. So, I think that how we define ‘‘world-class’’ can’t be defined just for one facility, it’s going to need to be defined for the MHS. Keeping that in mind as we do this, I think, is important. Chairman INOUYE. In terms of dollars, how much is involved? Admiral ROBINSON. Sir, at this point, the buildings—and, forgive me, I don’t do this on a daily basis, but I think we’re at the $1.5 billion level, in terms of facilities, but I think that the addition that will be needed is truly unclear at this moment. The additional funding that we—that is being talked about by the JTF CAPMED is in the $800 million range, but I don’t think that that is a number that—I don’t think that is the end number, and I don’t think— I don’t know the analysis behind that number. So, unfortunately, I’m not able to give you a very good answer regarding that. Chairman INOUYE. May I request that, for the record, a detailed response be made? Admiral ROBINSON. Yes, sir, we’ll do that. Chairman INOUYE. Thank you. Admiral ROBINSON. You’re welcome. [The information follows:] To carry out the 2005 BRAC law, JTF CAPMED was established to oversee the realignment of Walter Reed Army Medical Center to the new Walter Reed National Military Medical Center in Bethesda and Fort Belvoir Community Hospital. JTF CAPMED reports to the Secretary of Defense through the Deputy Secretary of De- fense. Due to the alignment of JTF CAPMED as an independent DOD entity, Navy Medicine does not direct JTF CAPMED on construction or other priorities, nor are we planning for future operation and maintenance requirements, since that by definition belongs to JTF CAPMED. These emerging priorities and requirements are driven by many things, all of which are outside Navy Medicine’s budget process. As part of our mission to ensure that our Wounded Warriors receive the care they need and deserve, Navy Medicine is in regular communication with JTF CAPMED and continues to provide support as necessary. Because of this regular communication Navy Medicine is aware of the unique challenges facing JTF CAPMED, to include the projected increase of financial requirements. However, specific details of these challenges or the financial requirements cannot be defined or defended by Navy Medicine. Chairman INOUYE. And now, General Green, on the matter of recruiting and retaining, we have noted that, for example, in medical schools today, about one-half of the graduates are women, but, on an average throughout the services—in the Medical Corps, I think it’s 72 percent men and 28 percent women. And it’s the same thing in the Dental Corps; it’s about 75–25. Is a special effort being made to recruit women, or is that part of culture? General GREEN. Sir, we have looked at many avenues to try and increase our attractiveness to women graduating from medical school. Many times, it comes up to, as they look at life choices and raising a family, concerns over time away from that family, et cetera, play into this. And so, one of the things that we’ve been looking at is whether we could do something with the Reserves, 97 which would allow people to come on Active Duty, basically pay back a portion of their commitment, and, as some life-changing event occurred, could there be a way to let them go into a Reserve commitment for a period of time, and then come back to us on Ac- tive Duty? These things have many implications regarding how a career is managed and whether or not they can be competitive with others, to make certain that we do not limit them in any way in their career planning. And so, we have done some research, actually gone out and talked with medical schools, looked at reasons why we have not been attractive. And, for the most part, it is not that our scholarships are not attractive to these folks, it’s not that we don’t have very successful scholarship programs, it has to do with concerns over lifestyle and the ability to adjust to things like childbirth, marriage, and changes in their own personal situation. And so, we’ll continue to very actively try and attract those folks. We realize that more than 50 percent of medical school graduates now are women, and we very much want to bring them in; we simply have not yet found a way to make ourselves attractive and change those percentages that you have quoted to us, sir. Chairman INOUYE. How would you rate our retention and recruiting? Excellent? Good? Fair? General GREEN. We have taken a different approach in the Air Force. As you know, we did not have a great deal of success in bringing in fully qualified, and so, we decided to move dollars from our recruiting into scholarship programs, and have significantly increased the scholarships that we are offering. We have done very well. We have three areas that we are having troubles right now; in particular, it’s with psychologists, oral surgeons, and pharmacists. And so, we are hoping to offer some more scholarships in those lines. When we go after people who are interested in pursuing education, we find that we have always been able to fill nearly 100 percent. We had one year where we were at 98 percent. Whereas, when we went after fully qualified, we frequently were not able to get even one-half of what we were trying to achieve. With our nurses this year, with the changes we’ve made in recruiting, we have seen a decrease in our ability to bring nurses in. Whereas, the other two services, in their recruiting, have brought in, I believe, very close to 100 percent of their nurses that they need, this year we were only able to bring in about 81 percent. Now, our nurse manning statistics are good. We’re sitting at about 90 percent. And our efforts have shifted again to try and use the enlisted to nursing, and we’re going to be bringing in about 50 enlisted members per year, which we think will fill the gap. I will let General Siniscalchi talk a little bit as to some of the things that we’re also doing to establish relationships with the nursing schools to show the benefits of an Air Force career. I don’t think that we’re falling behind, in terms of our changes in how we approach recruiting, but some of the efforts, in terms of the scholarships and things, have long tails. As you know, to graduate a physician—I’ll use a family physician—4 years of medical school and 3 years of residency. And so, from the time they take the scholarship to the time we see them coming out is about 7 98 years. And so, we are very interested in maintaining our ability to bring in fully qualified. We are leveraging the special pays and authorities that you have given us, to make certain that we can bring in people who are interested in an Air Force career. Chairman INOUYE. Thank you. General Schoomaker and Admiral Robinson, for the record, will you submit a paper on recruiting and retention? Admiral ROBINSON. Yes, sir. General SCHOOMAKER. Absolutely, sir. [The information follows:] The Army Medical Department is experiencing shortages in certain specialties and in certain locations. However, despite the persistent deployment tempo, the national shortage of many healthcare disciplines, and the compensation gap between military and civilian providers, the Army is doing well recruiting and retaining healthcare providers. Recruiting and retention authorities and bonuses are working, but we need to maintain constant vigilance. The most difficult skill sets to recruit and retain are fully qualified physicians with surgical or primary care specialties, dentists (general and specialty), behavioral health professionals, and nurse anesthetists. According to the U.S. Army Recruiting Command (USAREC), one of the greatest challenges in the recruitment of health professionals is simply a lack of awareness of military medicine in general and Army Medicine in particular. In an attempt to alleviate this challenge, USAREC is adopting a strategy of increased marketing of the benefits of Army Medicine. Mission success within the active force continues to rely on recruitment into our student programs. The world-class training programs offered by the Army Medical Department are critical to recruiting and retaining providers. Graduates of Army medical training programs enjoy a first-time board pass rate well above the national average. The Critical Skills Accession Bonus granted by Congress has been fundamental in turning around recruitment into the Health Professions Scholarship Program. In fiscal year 2009, we were able to recruit 103 percent of mission for dental students, 103 percent of Veterinary Corps recruiting missions, and 93 percent for medical students. These are significant increases from previous fiscal years and will be the building blocks for the future force. The Active Duty Health Professions Loan Repayment program has been very successful with 256 officers participating and receiving up to $44,000 annually. The average continuation rate of healthcare personnel (the percentage of personnel who, at their first opportunity to leave service, choose to remain) has averaged 92.5 percent over the last 5 years, peaking at 93.7 percent in 2009. Health Professions Spe- cial Pays are a key element in the retention of health professions. The new Consoli- dated Special Authority authorized by Congress provides increased flexibility for which we are grateful. We must continue to make full use of the recruiting and retention authorities and bonuses provided by Congress if we are to maintain strong recruiting and retention. Our experience over the last decade has proven that incentives, bonuses, and special pays work. Recruiting for Navy Medical Department active duty is good to very good. Navy Medicine recruiting efforts have been successful the past few years in making overall goal for all Corps in fiscal year 2008 and fiscal year 2009. Active Duty recruiting is projected to meet or exceed fiscal year 2010 goals with fiscal year 2010 recruiting performance outpacing the fiscal year 2009 effort. There continues to be difficulty in directly accessing wartime specialties and medical specialties that are highly compensated in the civilian sector. Retention for Navy Medical Department active duty is fair to good. Retention has stabilized over the past years due to increased retention bonuses. The overall loss rate for the officer corps was approximately 9 percent. The following provides a short synopsis of each of the Corps’ issues. Medical Corps We continue to experience difficulty in recruiting mental health providers, possibly due to the increased demand in the civilian sector. Recruiting and retaining general surgeons, preventive medicine, occupational medicine, family medicine, and psychiatrists will remain a challenge over the next 5 years. Wartime demand, perceived inequities in pay comparability between military and civilian providers, and limited student pipelines are contributing factors. 99

Dental Corps Dental Corps has difficulty directly accessing and retaining oral surgeons and general dentists because of the pay gap between military and civilian compensation. A general dentist pay package offering significant compensation increases is currently routing through DOD. Additionally, the DOD Health Professions Incentive Working Group will be recommending a $20,000 per year increase in incentive special pay for oral surgeons in fiscal year 2011. Medical Service Corps High operational commitments are affecting retention for physician assistants, clinical psychologists and social workers. The new accession and retention bonuses recently approved should have a positive impact on these specialties. Recruiting for clinical psychologists, podiatrists, and pharmacists is difficult because of the perceived inequities in pay comparability between military and civilian providers. Nurse Corps High operational commitments are affecting retention in all of Navy’s nurse practitioner specialties. Current initiatives in place to retain these critically manned/high OPTEMPO communities include RN Incentive Special Pay, Health Professional Loan Repay- ment Program, and a progressive Duty Under Instruction (DUINS) program for which officers are eligible after the first permanent duty station. Hospital Corps The Hospital Corps has been very successful at both recruiting and retaining corpsman. General SCHOOMAKER. If I could just make one comment—— Chairman INOUYE. Sure. General SCHOOMAKER [continuing]. From the earlier discussion about the recruiting bonuses. RECRUITING CIVILIAN PROVIDERS Army medicine is 60 percent civilian. I—for people who might be listening or reading this account, I’d very much like to encourage people who are looking for a career as a civilian in the medical services of the uniformed services, to come and look at us, to include women who might be looking at—we’re experimenting and looking at the potential for job-sharing around a single position, split between, you know, multiple civilian physicians, psychologists, psychiatrists, and the like. Chairman INOUYE. Thank you. Senator Cochran. Senator COCHRAN. Mr. Chairman, thank you. General Green, I was noticing a newspaper report discussing a medical group at Keesler Air Force Base, in Biloxi, Mississippi, assembling to provide emergency medical service in Chile for the victims of the earthquake there. And the numbers of people who are being treated by this special unit that’s flown from our State is in the neighborhood of 3,000 to 5,000 people, and making available care from the Medical Support Squadron that was based in Biloxi, Mississippi. Have you had any recent report? This is a 2- or 3-day-old report from a newspaper at—the Biloxi Sun Herald in Mississippi. General GREEN. Sir, that team went to Wilford Hall. They aggregated with their equipment in San Antonio, and left, I believe, late yesterday, are expected to arrive in Chile today. They will be working very closely with the Chileans, in terms of trying to decompress healthcare issues that arise whenever the healthcare infrastructure 100 has been damaged. We built our EMEDS–25, which is the unit that’s gone down there, based on the number of patients that they can actually see. That particular unit that has gone to Chile is an EMEDS–25. I believe it’s just over 65 medical folks, and another 20 to 30 support people, that basically help with water and electricity and making sure the hospital has all of its needs met. The intent is for them to augment the Chilean system. We’ll work hand-in-hand with the Chilean doctors. And they will probably, I would guess—before the end of their deployment, probably see in the neighborhood of between 3,000 and 10,000 patients. We maintain a robust supply channel to get that to them. And you may wonder, How do you see so many patients with so few? And the answer is that, when you’re working hand-in-hand with a host nation a lot is possible. As long as you have a good logistics chain and the ability to move patients back into the host-nation hospital, we find that we have tremendous capabilities. And these have been used both here in the States and overseas. Keesler did a superb job of mobilizing their people in less than 24 hours from the time they were notified. And a very excited group from Mississippi have gone to do this important work for our country. Senator COCHRAN. Well, we appreciate that. And it’s very impressive to contemplate the amount of work and effort that went into this, mobilizing the people, getting everything organized and— it’s not just a drive to the neighborhood; it’s a long way to Chile. And it’s really remarkable, I think. And you’re to be congratulated, I think, as a service; and the Air Force personnel who are at Keesler, and those who are volunteering to make this trip, really deserve our highest praise and commendation. General GREEN. Thank you, sir, I’ll pass that to Brigadier Gen- eral Dan Wyman, our Commander down there. Senator COCHRAN. Well, thank you. I wonder, just as a general proposition, the extent to which our services are able to recruit and retain qualified medical personnel to provide healthcare services. When I was in the Navy, we had one medical doctor aboard our ship, a heavy cruiser. And I was impressed, though, by the corpsmen, who really make up the bulk of the people who do the work and provide healthcare services at sea like that, when you’re a long way from anywhere. They really do a marvelous job, sometimes with emergencies. I have to admit, I wasn’t in a military conflict when I was in the Navy. Some of the ports we visited might have thought we were in a military conflict, but—— Anyway, what is your assessment right now of our ability to retain and train competent people to do these very important jobs? General SCHOOMAKER. Is that directed to me, sir? Senator COCHRAN. Yes, sir. General SCHOOMAKER. To the Army? Senator COCHRAN. Right. VALUE OF COMBAT MEDICS General SCHOOMAKER. First of all, let me just make a comment, that I’m really pleased that you recognize. A lot of people don’t recognize the central role that our enlisted medics play in this. The 101 second largest military occupational specialist—the only larger population is that of infantrymen, 11 Bravos—is the combat medic, the 68 Whiskey. In fact, yesterday, we held a ceremony down in San Antonio, where my headquarters is, with—attended by five of my predecessors, Surgeons General, including now—former Secretary Jim Peake, who was the Surgeon General of the Army before that, and who conceived of the need to better train our medics. We now have the 68 Whiskey program—very highly trained medics. And, frankly, much of what my colleagues and I have talked about, in terms of success on the battlefield, is owed to our medics. Whether they’re Navy corpsmen, who are serving with marines, or our Air Force medics, these kids are just amazing human beings who have—who are truly heroic. So, I appreciate that you recognized that, and the role that they play. RECRUITING AND RETAINING OFFICERS As far as recruiting and retaining other officer-level specialties, we’re doing quite well, sir. We had—especially in the Nurse Corps and the Medical Corps, the physicians and nurses—some difficult years in the past, but last year, physician recruitment, through our Health Profession Scholarship Program, which is one of the center- pieces of that program, of bringing in kids interested in going to medical schools under scholarships from the military, has been very successful. That program is absolutely essential to us. It’s— in the Army, it’s well funded, both for the Active as well as the Re- serve component of it. And we’re seeing the products of it. Our graduate health education, and specifically physician graduate education programs, and our nurse graduate programs, I think are essential for retention of those high quality people. If we didn’t have those programs, frankly, I don’t think we would be doing as well as we do, because we recruit successfully through the scholarship programs or loan repayment programs, but we retain them through offering to them some of the very best training programs for physicians and nurses that exists anywhere in the country. Senator COCHRAN. Admiral Robinson, I didn’t mean to overlook your opportunity of serving the Navy in the position you do. We appreciate your service. And I—what is your reaction to that same question? Admiral ROBINSON. Senator Cochran, thanks very much. First of all, the corpsmen are the backbone of Navy medicine. And you noted that—one doctor on your ship, but there were more—there were probably several corpsmen. Today, in our submarine force and surface force, independent-duty corpsmen very often are department heads for the medical departments. So, we actually count on these men and women to give first-rate medical care at sea to a large number of our forces. And they are qualified to do that, and they do a good job, and have been doing that for the last 50 years. So, it’s not a new program; it’s something that we’ve had in place, and we need to continue. The 8,404 corpsmen, who are corpsmen with the Marine Corps, do an outstanding job, both from integrating with the marines, but also from taking care of marines and people in harm’s way. And, 102 unfortunately, the largest number of casualties and mortalities that we have in Navy medicine over the course of the last many years actually is a result of the death of 8,404 corpsmen, my corpsmen who are with the Marine Corps. So, the point is that the sacrifice and the bravery and the quality of the care that the men and women who are corpsmen and who are enlisted medics give is a testimony to the mortality/morbidity rates coming out of theater, out of the battlefield, and also testimony to en route care, to the surgical care, to the care that’s received at Landstuhl, and the care that’s received here. So, it’s a continuum of care that starts with that combat medic, with that corpsman on the battlefield, that’s able to reach out and actually do an effective job. And recruitment and retention—Navy medicine, I think I almost will parallel completely what General Schoomaker said. We’ve had some poor years, but recently we have had good recruiting and retention numbers on the Active component side of our physicians. We are down in family practice, general surgery, in terms of critical specialties that we need more of, and also psychiatry, mental health, but we are doing a great job, and I feel very happy that the Health Profession Scholarship Program and several of our other programs are back up and are actually producing quite well. On the Reserve side, there are some challenges that we’re having, and I think that the challenges—we’ve looked at this, and I think the challenges in the medical recruiting portion may be related to how we changed the recruiting several years; instead of having an Active component and a Reserve component recruiter, we put the recruiters together. And I think that, at that point, as soon as the Active component member was obtained, as it were, I don’t know if the emphasis was put on the Reserve component. We separated that out again, and we’re going to look at this very hard, but I think we’re going to see an uptick in the Reserve component recruiting that’s occurring. That’s something that’s on my radar screen, but right now, recruitment and retention in medical is all right—and I don’t want to overplay this—we’re looking hard, but it’s okay, and it’s better than it’s been in the last several years. Senator COCHRAN. Great. Thank you very much. Mr. Chairman. Chairman INOUYE. Thank you. Senator Murray. Senator MURRAY. Thank you very much, Mr. Chairman. This hearing really does come at a critical time. We’re in the seventh year in Iraq, and are increasing our operations in Afghani- stan. And the Department of Defense continues to see our returning members come home with both visible and invisible wounds of war. I know that you’ve all made a lot of progress, but we know our job’s not finished. We need to make sure that all of our members and their families have access to healthcare at all times, and we can’t forget to—our wounded warriors, our reservists, National Guard and Active Duty servicemembers, as they transition back to civilian life, and make sure that we’re meeting all their needs. 103 To that end, I wanted to ask you specifically about the National Guard and Reserves. They’ve been called on a number of times to support us, and they’re coming home to some real hardships, with the economy that is very difficult for all of us, but particularly for them. Some of them come home to no jobs when they’re released from Active Duty, and healthcare becomes an issue for them, as well. In some cases, the returning National Guard and Reserve soldiers have to live off limited savings or their drill pay to support their families. And, you know, that contributes to greater mental health stress for them. So, I’m very worried about how we’re dealing with this right now. And I wanted to ask all of you what kind of efforts are currently underway to improve access to mental healthcare during the dwell period for our National Guard and Reserve. Open it up to any of you who’d like to comment. MENTAL HEALTHCARE FOR RESERVE COMPONENT General SCHOOMAKER. First of all, ma’am, we share with you the concern about the strain on the Active—the Army National Guard and the Reserves. This period of transformation for the Army, as you know, has been a transition from the reliance on our Reserves as a strategic reserve poised to be mobilized in the event of a strategic threat to the Nation on a large scale, to one of an operational reserve, where they are very much involved in continuous operations and mobilization and deployment. Our first goal, across the board, in terms of health, dental, mental, and physical care, is at separation and demobilization, to fully explore what problems—and, in the case of dental health, to restore dental health; in the case of behavioral health problems, to comprehensively evaluate how the soldier is doing. And, I think, in the National Guard and Reserves, we still have a way to go with that. Our Vice Chief of Staff of the Army, General Chiarelli, last year, recognized that access to healthcare for the National Guard and Reserve, who tend to live in sites remote from our installations and in the heartland, often in rural areas, does not have the access to care, even under TRICARE, that we would like. And we have a— he chartered, through Army medicine, a task force, co-chaired by Major General Rich Stone, in the Army Reserves, and Major Gen- eral Deborah Wheeling, in the National Guard, to bring together leaders in TRICARE, leaders in the managed-care support contracts across the country, and for all—from all the State’s Guards and others, to identify our problems in getting access to care, and to improve that. And that’s a work in progress, ma’am, but we share your concerns. Senator MURRAY. Well, particularly now. These Guard and Re- serve members are coming home; many of them are living at or below the poverty line, including their drill pay, and they just— they don’t have a job and they don’t have health insurance. I know we take care of them prior to deployment. I think it’s 6 months prior to deployment, they get healthcare. But, they come home, and they don’t have anything during dwell time. You’re going to call them up again, you know, in a year or two, and that becomes both 104 a recruitment issue for you, but it’s also a real hardship on their families. And what are we doing to look at that? General SCHOOMAKER. I think the first thing that we’ve been working on with you all is an extended benefit through TRICARE Reserve Select and other forms of TRICARE coverage, to reduce the benefit—excuse me—reduce the premium load on National Guard and reservists—— Senator MURRAY. During dwell time. General SCHOOMAKER. Yes, ma’am—so that they can get access to care. There’s no question that—— Senator MURRAY. So, is it an issue of budget or is it an issue of policy? What is it that—— General SCHOOMAKER. I think it’s a combination of things. It’s focus from Commanders. We’ve got Reserve component National Guard and Reserve commanders now focusing more on their soldiers’ comprehensive health benefits when they’re in dwell, and putting emphasis on that. It’s choices you’ve outlined, yourself, ma’am, that when a soldier has a limited budget, and part of that is even for a modest premium for a TRICARE benefit, they often choose not to do that. And, frankly, as you know, young people often kind of take risk that they’re not going to run into health problems, and so, they forego health benefits, for that reason. And I think, more and more, we’re emphasizing the importance and the need for them to retain their medical and dental readiness, even in dwell. NATIONAL GUARD AND RESERVES Senator MURRAY. Well, I think it’s a policy that we need to look at and really focus on. We’re a long ways into the war in Iraq, and, with a lot of returning soldiers, we know that’s going to go on for some time, particularly in Afghanistan, and I’m very concerned about that, so I hope we can explore that. Does anybody else have a comment on that issue? Admiral. Admiral ROBINSON. Senator Murray, I think that the TRICARE Reserve Select is part of the answer. And that benefit, if I’m not mistaken, has been extended to the Reserve forces, because, certainly, the beneficiary numbers in the TRICARE system have increased, and I think part of that increase is that. The second thing is that—and this is only for 180 days—it’s only for 6 months, but the Active Duty, Reserve members that are coming off of Active Duty can still be covered, and their families can be covered with TRICARE for that 180-day period. So, marrying those two with the Reserve Select program and the 180 days can be of some benefit, in terms of getting the care that they need. In terms of the mental health coverage, on the Navy side the psychological—the Reserve Psychological Outreach Program and the Reserve Psychological Outreach Teams, which consists of about 24 to 25 social workers, are doing a good job of going to the Navy Operational Reserve Centers—the NOSCs are what they’re called— and they have actually been reaching out to just under about 20,000 to 25,000 people. They have seen 1,700 people and referred people to mental health coverage. It’s a small part, but it’s the in- 105 creased focus on getting out into the heartland areas, the areas away from the medical centers, and also taking care of—— Senator MURRAY. Yup. Admiral ROBINSON [continuing]. Those people, who aren’t seen regularly. Senator MURRAY. Right. But, we’ve been talking about this for a long time, so I’m frustrated that we’re not doing better than we are today. Admiral ROBINSON. We are doing better, but we’re not doing all that we need to do. I would frame it in, in that direction. Senator MURRAY. And I agree. I think that’s fair. But, we’re—we still have a big problem out there. Admiral ROBINSON. Yes, ma’am, we do. Senator MURRAY. General. General GREEN. I think all the services share in their medical continuation, in terms of any problems that are identified from their deployments. We also all have the same survey systems that are applied, regardless—Active Duty, Reserve, or Guard—with the post-deployment surveys and the PDHRAs at about 6 months. We’re looking for any problems that may have developed in the interim. The medical continuation is one of those things where any problem that looks like it’s associated with deployment, that they need to remain on Active Duty, we try and get that resolved by extending their orders and keeping them there. And the TRICARE Re- serve Select is available to them for 6 months post. We also have programs that haven’t been mentioned here such as the Yellow Ribbon Program—— Senator MURRAY. Right. General GREEN [continuing]. That are designed to try and help people find services and to ensure that they’re getting some assistance. We’re looking—the Army, in—particularly, is looking at some telemental-health, in terms of how we can also be of assistance that way. And all the services are looking at these things because we see some of the gaps that you see, and are trying to close those gaps as best we can. Senator MURRAY. Okay. General Schoomaker, I wanted to ask you about the issue of suicides. In January of this year, the Army released information that there were 160 suicides of Active Duty soldiers in 2009, 140 in 2008. For Reserve soldiers, you reported 78 suicides; 2009, 57. That increase in military suicides is really disturbing to me. And I think we need to be doing everything we can to make sure that we identify and mitigate the issues that are leading up to these unfortu- nate incidences. I wanted to ask you, What measures or programs has the Department of Defense instituted to mitigate future suicides? And what are we doing out there? SUICIDE PREVENTION General SCHOOMAKER. Ma’am, I think all the services, but certainly the Army, shares with you the concern that we’ve had about suicides. We’ve seen an increase, over the last 5 or 6 years, from a suicide rate within the Army that roughly was one-half of the benchmark, you know, age- and gender-adjusted statistics in the ci- 106 vilian sector, to one that now has risen to be almost in parallel with. It’s hard to tell, in the civilian sector, because the civilian- sector numbers that are released by the Centers for Disease Con- trol are 2 years after the fact, so we won’t see 2009 statistics until 2011. But, this is a—this is an issue which the highest levels of the Army have taken responsibility for. The Vice Chief of Staff of the Army has chartered a task force. For the past year, they’ve looked very, very carefully at all factors across—— Senator MURRAY. Is this the National Institutes of Health study? General SCHOOMAKER. No, ma’am, that’s actually an additional piece of this. The STARRS program—the acronym for which I just blocked—but, the STARRS program is a $50 million, 5-year program that the Secretary of the Army chartered last year—with the National Institutes of Health, with University of Michigan, with Johns Hopkins—looking very carefully at all of the factors—what’s been described as a Framingham Study that was done in Fra- mingham, Massachusetts, beginning in the 1940s, looking at the risk factors for heart disease, and has changed our whole approach, nationally, to public health measures around heart disease. The same methodology is now being applied to suicide and suicide prevention. But, within the Army itself, we’re very actively looking at all of the factors that go into this rising suicide rate. There is no one single factor we can put our finger on. Roughly one-third of our suicides occur in people who have never deployed at all. Roughly one- third occur in soldiers who are downrange and deployed. And one- third are in those that have deployed once or twice within the last several years. And the one transcendent factor that we seem to have, if there’s any one that’s associated with it, is fractured relationships of some sort, either a broken marriage, a girlfriend/boyfriend, even a relationship that might have been forged with the Army itself, as a very tight association a soldier made may develop, and then maybe does something that gets him administratively punished or, you know, nonjudicial punishment, and they go out and kill themselves. And so, we’re looking at all of those related factors—alcohol and drug abuse that may be associated with it—because this is an im- pulsive act, frequently lubricated by alcohol or drugs, and we are, as an Army, very, very focused on how we can improve it. At the Department level, there’s a task force that has been chartered by the Secretary. In fact, Major General Phil Volpe, one of my physicians, is a co-chair of that task force, right now is looking at DOD-wide programs and how we can, in a unified way, take efforts to prevent suicide and better understand it. Senator MURRAY. Okay. Well, I would like to work with all of you and, you know, have a—get as much information as possible. If we need to be doing more, in terms of support services, outreach, whatever, I think we really need to focus on that issue. MENTAL HEALTH AWARENESS General SCHOOMAKER. Yes, ma’am, we welcome it. Senator MURRAY. Air Force or Navy, either one of you want to comment on what your services are doing to promote mental health awareness or—are either of you doing studies, long term, on this? 107

Admiral ROBINSON. Studies, I cannot answer. I can tell you that, in terms of the awareness and in terms of trying to do education and training, trying to make sure that we make this an imperative and a leadership imperative for all of our Commanders, making sure that we decrease the stigma of getting mental healthcare, which has been quite pervasive and is really a deterrent to people who need to get care, and also to the establishment in our operational stress programs, both in combat, but also—I’m talking—not in combat, now; I’m talking about operational stress—in noncombat situations, and also our caregivers’ operational stress programs, because they often are under a great deal of stress—making sure that we have primary care members—and a great deal of the mental healthcare that is given to individuals, around the country, but certainly in the services, is given by family practitioners and primary health providers, and making sure that they have training and that they understand what is going on. The dependent—the Deployment Health Clinics, the 17 that we have in the Navy, about one-third of the people that are coming in are coming in for mental health issues. And the nice thing is, no one knows why you’re going into that clinic, but we have embedded psychiatrists, psychologists, and primary care members in that clinic, so you can be referred immediately and talk to someone, and get the care that you need. I think, also, one additional thing, and that is the ACT Program, that we take to the deckplates, as we say; and that is, each man and woman, each person, each shipmate, can do the ACT. The ‘‘Ask,’’ ‘‘Are you thinking about harming yourself?’’ The ‘‘C’’ is the ‘‘Care,’’ the care to say, ‘‘I think you need some help. I think you need to see a chaplain. I think you need to go someplace.’’ And then, the ‘‘T’’ part is the ‘‘Treat,’’ and that is to actually make sure that people get to that level. The continuum of care that we try to give indicates that everyone—every person in the Navy, civilian and Active Duty, in war and out of war—is responsible for their shipmate and is responsible—we’re responsible for one another. Senator MURRAY. General Green. General GREEN. The Air Force, since 1997, has had a very successful Suicide Prevention Program, basically focused on 11 suicide prevention initiatives, most of that focused on very close focus by leadership, in terms of getting our wingman program out and making certain that everyone understands that this is not acceptable. With those 11 suicide prevention initiatives, we were actually able to decrease our rate below 10, for probably 5 to 7 years—10 per 100,000. Over the last 3 years, we have seen slight increases back to about our 1997 rate. We are also trying to reinvigorate our program. Actually, we work very closely together across the services to do that. We do have one study that the Air Force has funded, different than the others, because we were very interested, in particular, with civilian suicides, because of some events that have been happening that have made the news out at Hill Air Force Base. And so, we had the RAND Corporation look at some of our initiatives out there to try and create a first-sergeant equivalent, people who could be there and be kind of initial capability to help civilians find 108 assistance in an area that did not have all the mental health support that it needed. And then, we’ve also put, in our occupational clinics out there, a mental health social worker to try and assist with some of that. We did also identify that we have about three times the rate of the rest of the Air Force in two career fields, in security forces and in intel career fields. We are taking a very targeted approach with those career fields to try and do face-to-face interventions with much smaller groups, using some of our video vignettes, similar to that used in our computer-based training. We are also mandating those front-line supervisors will receive specific suicide training. Because our program’s been in place since 1997, it is in our PME schools, it is in our basic training schools. And so, I think we’ll continue to have success. Our rates are probably about—not quite one- half of what the other services are. But, we believe our programs are still valid, and we’re just emphasizing and trying to focus them where we see problems. Senator MURRAY. Okay. I really appreciate all of your focus and attention on this. I think it’s extremely important. And I know I’m out of time, Mr. Chairman, and you’ve been generous. I do want to submit some questions for the record. One, in particular, that I want to hear back from all of you on is what we’re doing for children of servicemembers today. We have a lot of families out there who have sacrificed a heck of a lot in a very tough economic climate, and I know who bears the brunt often is the kids of those families, and I’d like to hear back from each one of you what you are doing uniquely with our families and what we, as Congress, ought to be doing, or can be doing, to better support the children of the members of our services. SUPPORTING FAMILIES AND CHILDREN General SCHOOMAKER. Yes, ma’am. We would love the—to participate in that. As you know, one of the centers of this is in your State, at Madigan Army Medical Center. It’s one of our centers for outreach for children. Ma’am, if I might, real quickly, append the record just to say, before I get hate mail from my colleagues at Uniformed Services Uni- versity of the Health Sciences, one of the pivotal players in this landmark study on suicide, the 5-year, $50 million study with the National Institutes of Mental Health is the Uniformed Services University of Health Sciences, Dr. Bob Ursano, who is really heading up this project. Senator MURRAY. Okay. Look forward to hearing much from that. Admiral. Admiral ROBINSON. Senator Murray, for your children—and this isn’t a complete answer, but a short one, because it actually came from this hearing, 2 years ago, but the FOCUS Program—Families Over Coming Under Stress—which was originally started with Navy in very small groups of mainly Special Ops families who had had such an intense OPTEMPO. And we have now seen some really excellent results with that program, in terms of marriage, counseling. I can’t say that all the marriages are successful, but there’s 109 been a reduced rate of divorce, there’s been a reduced rate of children involved in drugs and in other acting-out behaviors. It’s a program that’s focused on spouse and children, and it’s been very successful. And it’s being incorporated, now, into not only Navy, but also Army and Air Force. Senator MURRAY. I’d like to get a briefing on that, if you could tell me what you’re doing and how it’s working—— Admiral ROBINSON. Certainly. Senator MURRAY [continuing]. And what some of your statistics are. That would be great. Admiral ROBINSON. I’ll be happy to do that. [The information follows:] Project FOCUS (Families Over Coming Under Stress) Outcome Metrics FOCUS has demonstrated that a family-centered targeted prevention program is feasible and effective for military families. Utilizing national and local partnerships, community outreach, and flexible and family friendly skills-based approach, FOCUS has successfully initiated a resiliency training program in collaboration with the military community. FOCUS has demonstrated that a strength-based approach to building child and family resiliency skills is well received by service members and their family members reflected in high satisfaction ratings. Notably, program participation has resulted in significant increases in family and child positive coping and significant reductions in parent and child distress over time, suggesting longer- term benefits for military family wellness. Standardization in program implementation provides the foundation for FOCUS program implementation and sustainability to support larger scale dissemination. Current Service Metrics Total all FOCUS Services to date at all sites: 92,000. —Navy: 40,000 (services began March 2008). —Marine Corps: 50,000 (services began March 2008). —Army: 2,000 (services began November 2009). —Air Force: 600 (services began November 2009). Specific outcomes of program interventions as measured by validated and standard metrics used in psychological health surveys are: —Pre- and post-intervention levels of overall psychosocial functioning of program participants (both adults and children), suggest a significant improvement. The statistical level of significance is p < .001 level. —Pre- and post-intervention levels of general emotional stress suggest a significant reduction in depression, anxiety, and somatic complaints on the part of adult care givers. The statistical level of significance is p < .01. —Change scores on 6 dimensions of family functioning were found to be highly significant at the p < .0001 level of statistical significance. This suggests a marked level of improvement across areas such as behavior control, problem solving, communication, affective involvement and responsiveness, and general level of family functioning. Project FOCUS surveyed both parents and child participants and found a high level of overall satisfaction with FOCUS services. The average of all respondents on levels of satisfaction is reported below. A rating of 7 was the highest possible rating: 6.54 for ‘‘program was very helpful’’; 6.59 for consumers being ‘‘very satisfied’’; and 6.73 for consumers who would ‘‘recommended the program to others’’. In summary, since Project FOCUS has been in operation, ongoing and multiple assessments of program effectiveness have repeatedly shown that the program is worthy of being viewed as a model program for military families. Senator MURRAY. Very good. Admiral ROBINSON. Thank you. Senator MURRAY. Thank you very much. Thank you. Chairman INOUYE. Thank you. General Schoomaker, Admiral Robinson, and General Green, I thank you very much. Chairman INOUYE. And we’ll now listen to the second panel, a very important one. 110 I’d like to welcome back Major General Patricia Horoho, Chief of the U.S. Army Nurse’s Corps; and Major General Kimberly Siniscalchi, Assistant Air Force Surgeon General for Nursing Serv- ices; and I’d also like to extend a special welcome and congratulations to the newly appointed Director of the Navy Nurse Corps, Rear Admiral Karen Flaherty. I’d like to also extend my congratulations to General Horoho for being selected to serve as U.S. Army Deputy Surgeon General and also as the Nurse Corps Chief. As all of you know, I did have the privilege of serving in the Army, and spent about 20 months in various hospitals. And at that time, I saw the doctor about once a week, and the nurses 24 hours, 7 days a week. And, as a result, I looked upon them as special angels, in my case. They helped prepare me to get back into life. Today, you have patients with problems that did not exist in World War II. For example, in my regiment, with all the casualties, there wasn’t a single survivor of double amputation, no survivor of brain injuries. But, these are becoming commonplace now, because—for example, in my case, it took 9 hours to evacuate me by stretcher. Today, if it were in Afghanistan or Iraq, I’d be evacuated in about 30 minutes by helicopter. And so, the survival rate is extremely high. And added to this, you have cell phones, daily telephone calls between husbands and wives, and CNN telling you what’s happening out there. And so, the stress is not only limited to soldiers, airmen, and marines, but also the family. Do you think that nurses are adequately prepared and trained to serve men and women with problems that didn’t exist during my time? General Horoho. General HOROHO. Thank you, Mr. Chairman. PREPARED STATEMENTS Chairman INOUYE. Your statements have been made part of the record, so—— General HOROHO. I’m sorry, sir? Chairman INOUYE. Your full statements are part of the record now. General HOROHO. Okay. [The statements follow:]

PREPARED STATEMENT OF MAJOR GENERAL PATRICIA D. HOROHO Mr. Chairman and distinguished members of the committee, it is an honor and a great privilege to speak before you today on behalf of the nearly 40,000 Active component, Reserve component and National Guard officers, non-commissioned officers, enlisted and civilians that represent Army Nursing. It has been your continued tremendous support that has enabled Army Nursing, in support of Army Medicine, to provide the highest quality care for those who are entrusted to our care. Last year I promised you an update on the Army Nurse Corps Campaign Plan that we began in October 2008. It became evident that our efforts to transform Army Nursing mirrored the desire of national nursing organizations and their leaders to improve nursing practice in support of the healthcare reform initiative. Today I will share with you some of Army Nursing’s accomplishments that are leading national nursing initiatives as well as some of the challenges that we will face in the years ahead. 111

LEADER DEVELOPMENT: BUILD OUR BENCH The first priority for Army Nursing is to develop full spectrum Army nurse leaders. Considering our Nation’s continuous engagement in overseas contingency operations and the complex clinical challenges our nurse officers face both home and abroad, I challenged my senior leaders to develop training platforms that will prepare our nurses to succeed in any contingency-based operation around the world. Identifying the need for a clinical transition program for new graduate Army Nurses, the Army Medical Command (MEDCOM) formally fielded the BG (R) Anna Mae Hayes Clinical Transition Program (CTP), named in honor of our 13th Corps Chief, across nine medical centers beginning in October 2008. During fiscal year 2009, 364 new graduate Army Nurses completed this program. Throughout the year, the program was standardized to decrease the variance among the nine program sites. Thus far in fiscal year 2010, over 270 nurses have graduated from the program. Their enthusiastic endorsement of the program usually ends with the question ‘‘when can I deploy?’’ Our nurses take great pride in wearing the cloth of our nation. After graduating from the Officer Basic Leader Course, the new nurse officer enters the Leader Acad- emy via the CTP. This program is based on the Army leader development strategy that articulates the characteristics we desire in our Army leaders as they progress through their careers. The CTP is a 25.5 week program designed to bridge the baccalaureate education and professional practice of the New Graduate Army Nurse (NGAN). It consists of three formal phases (orientation, preceptorship, and clinical immersion) developed to foster critical thinking, communication, and deployment skills. Incorporated into the phases are a 5-hour monthly didactic seminar, journal club, and research review with a focus on leadership, professional role development, and improvement of patient outcomes. The CTP is congruent with the National Col- lege of State Boards of Nursing’s intent to require residency programs for new nurses. Initial review of survey data collected during fiscal year 2009 reveals NGAN positive responses to the following domains of new graduate nurse satisfaction: intent to stay, confidence levels in individual practice, and enthusiasm for the practice of nursing. The responses of the NGANs were similar to the published survey results from civilian clinical nurse transition programs. With the key elements of this program standardized, outcome variables related to risk management (such as medication errors, patient falls, and failure to rescue) can now be evaluated in fiscal year 2010. The first course that we realigned in support of the Campaign Plan was the Head Nurse Course. It has been renamed the Clinical OIC and NCOIC Clinical Leader Development Course. The renaming is a result of acknowledgement of the critical relationship that exists between the Clinical Nurse, OIC (Officer in Charge) and their clinical right arm—the NCOIC (Non-Commissioned Officer in Charge). As an integrated training platform, this course has had very positive results. It provides our mid-level managers the opportunity to learn the critical skills needed for working as a team, and to master those skills in a simulated environment. This allows participants the opportunity to hone tactics and to learn techniques and procedures and decision-making skills that are used in the clinical environment. The training received in this course promotes cognitive competency and teamwork, and metrics are being developed to examine the program’s impact on patient outcomes. Twelve clinical NCOICs from across Army Medicine attended the Head Nurse Leader De- velopment Course as a pilot test October 2009. Due to the success of this pilot test, full attendance of Clinical NCOICs at this course is in the approval process. Both the CTP and the clinical leader development course are designed to prepare clinical leaders to be experts at navigating the complexities of care delivery in any environment. Through the past year we have leveraged the experience and expertise of our clinical Sergeants Major, as the senior enlisted advisors and subject matter experts on NCO and enlisted issues. They are our primary advisors on policies and regulatory guidance. Their voice and ideals have brought us a ‘‘results-based leadership’’ that has allowed us to excel in our imperatives and adopt a ‘‘new paradigm,’’ or view of the world. These NCOs could not accomplish their mission without the hard work and dedication of the men and women of the Army Medical Department (AMEDD) Enlisted Corps. It’s through their unrelenting compassion to save and heal, despite hardships and dangers to life and limb that makes them ‘‘angels on the battlefield.’’ We are committed to the growth and development of our NCOs and Soldiers. Therefore, starting in fiscal year 2011 we will fund two senior NCOs to obtain their Masters in Healthcare Administration which will ensure a continuous capability to meet the needs of the 21st Century. In addition, we are developing an Intensive 112

Care Unit course for our Licensed Practical Nurses (LPN); this additional capability will allow commanders the flexibility to use LPNs for transport of critical patients, improve patient outcomes, and expand practice opportunities. Finally, the Leader Academy facilitates enhanced career-long development of adaptive full spectrum Army Nurse Corps leaders through the level of Regional Nurse Executive (RNE). We adopted the American Organization of Nurse Executive competencies that include skills such as healthcare economics, and healthcare policy management as well as abilities in outcomes measurement and change management in order to ensure the RNEs have the knowledge, skills and behaviors to help manage the regions system of health. We leveraged George Mason University’s ‘‘Nursing Administrative Leadership Academy’’ into our own leader academy as a training platform for our RNEs. We are sending three of our RNEs to the program this summer. We are also selectively using AMEDD courses such as the Interagency Federal Executive and the Executive Skills Course to hone and refine the RNE’s abilities as influencers of the delivery of health. We believe the Army Nursing Leader Acad- emy is setting the standard nationally for how nurse leaders are prepared to have an active and influential voice in healthcare, AMEDD, and national nursing policy.

WARRIOR CARE: BACK TO BASICS Our second strategic imperative is to standardize nursing care delivery systems in order to perfect nursing care at the bedside. We created a Patient and Family centered System of Nursing Care (SOC) that has as its cornerstone standardized nursing practice. This SOC will not only enable the Surgeon General’s intent to improve and standardize care from the point of injury through evaluation and inpatient treatment and then return to duty, but will also enable, for the first time, comprehensive measurement and subsequent improvement of nurse-sensitive patient outcomes. We piloted elements of this SOC at Blanchfield Army Community Hospital, Fort Campbell, Kentucky, in January 2009. After 6 months of monitoring we identified notable improvements in care such that nurse sensitive errors declined, while compliance with quality initiatives increased. During the 6 month pilot period, we found a 44 percent decrease in nursing medication errors and a 100 percent decrease in risk management events. Additionally, patient pain reassessment improved from 90 percent to 99 percent and reporting of critical laboratory values improved from 92 percent to 100 percent. We realized several ‘‘quick wins’’ such as the marked improvement in how nursing staff communicate with patients and physicians. Unex- pectedly, we noted improvement in nurse retention metrics including a 24 percent increase in nurses’ opinions that they are rewarded for a job well done, and a 23 percent increase in nurses’ opinions that nurses are seen as important leaders in their organizations. Overall, nurses reported that they believed that they were being heard, and their opinions valued. One nurse at Blanchfield said ‘‘Now I feel like I have a voice in the organization.’’ Using the data from the Blanchfield pilot, we fully conceptualized the SOC as a three-sided pyramid with one side delineating clinical practice elements, another professional practice elements, and another business practice elements. The pyramid is anchored by the Army nursing triad; Army nurses, NCOs, and enlisted and civilians comprise its base. Next month, select elements of care are being implemented at three medical centers: Walter Reed Army Medical Center, Washington, DC; Brooke Army Medical Center, Fort Sam Houston, Texas; and Madigan Army Medical Center, Fort Lewis, Washington. For one element of the professional practice side of the pyramid, we are implementing an Army nursing creed—it is our nursing ethos and codifies who we are as nurses by articulating what we believe in and value as nurses; it is the heart of nursing practice. It includes Army values and the American Nurses Association Standards of Practice that allow us to define a standard level of nursing care common to all nurses and a standard level of behavior in the professional role. In April, at the same three hospitals, we are implementing nursing peer review that aligns a business strategy with clinical practice. Peer review is a best clinical business practice that enables us to retain the very best nurses who provide quality care as measured against our professional standards of practice. Peer review is a talent management tool that provides real time, constructive feedback to clinicians to assist with their professional growth which leads to good patient outcomes. In May, we will implement the Army Nurse Corps Practice Council along with unit-specific governance councils to support the clinical practice side of the pyramid. Governance councils will facilitate decentralized joint decisionmaking by nursing leaders and staff nurses at the frontline of care—the patient/nurse interface. These unit councils will collaborate with the Army Nurse Corps Practice Council to iden- 113 tify best practices relative to nursing tactics, techniques, and process, and then cod- ify these practices for standard use across Army Nursing. Army Nursing identified two best practices that were incorporated into the SOC. At Tripler Army Medical Center (TAMC), nurses modified environmental and staff behavior factors to tailor inpatient care to provide ‘‘Healing Hours.’’ The restorative importance of sleep is well documented, but hospitalized patients report many factors including noise, pain anxiety, light, and interruptions by hospital staff as sleep disruptors. To validate the most common sleep disruptors, TAMC nurses requested input from 227 patients over a 6 week period and received 135 responses. 71 percent of patients reported averaging less than 4 hours of sleep a night during their hospitalization. 62 percent reported their sleep being interrupted by a nurse or provider. With the information gathered, TAMC initiated the Healing Hours concept. Healing Hours are individualized based on diagnosis and requirement for hands-on care. The overall purpose of Healing Hours is to promote rest through consolidation of patient care activities. Ancillary services aligned their services to support this initiative. Pharmacy adjusted routine medication times to coincide with established rest hours. Routine laboratory service rounds do not begin before 0600 hours. Signs are posted on each patient’s door to remind all staff of requested Healing Hours. Patients are provided information during pre-admission activities to encourage them to bring comfort items from home; i.e. earplugs, earphones, and eye masks. At Walter Reed Army Medical Center, senior nursing leadership examined hourly nursing rounds as a measure to improve patient and staff outcomes. A total of 11 intensive, medical, surgical, and same day surgery units participated in the project, where we simultaneously measured outcomes such as patient satisfaction, staff satisfaction, falls, medication errors, and call light use. We compared pre and post intervention efficacy of hourly nursing rounds and found that within 4 months of the implementation of hourly rounds, patient outcomes, such as the use of call lights and patient falls decreased while patient satisfaction increased. In order to ensure implementation of innovative ways to deliver care to the inpatient, outpatient, and deployed environment, we are also moving forward with implementing team nursing, comprised of RN, LPN, and medics. This aspect of the SOC aligns with The Surgeon General’s (TSG) ‘‘Come Home to Army Medicine’’ campaign. This community based primary care will bring healthcare closer to home, standardize business practices, and develop the model for patient centered medical home. As we begin implementation of the SOC, our nurse researchers have begun the transformation of a geographically disparate one to three person research cells into the Offices of Nursing Science and Clinical Inquiry (NSCI). The NSCI will combine the resources of Research Ph.D. Scientists, Nurse Methods Analysts, Clinical Nurse Specialists, and the new DNP (Doctorate of Nursing Practice) with a robust mission that will provide decision support, evidence-based practice, and research. These NSCIs at each regional medical center will promote a shared vision across Army nursing using shared and capitalizing on shared resources and infrastructure. This change will shift emphasis in focus to capitalize on integration of evidence-based research into practice, improve warrior care, enable leader development and maximize human capital while addressing Army nursing priorities. This fundamental shift will transform Army nursing from an expert based practice to system based care and will provide the impetus to move toward a culture and workforce with the ability to develop research agendas and translate evidence into practice at the bedside. Currently the Army Nurse Corps has an inventory of 33 ANC Research Scientists and two civilian nurse scientists with doctoral degrees. Twenty-one of these are actively working in research assignments. In 2008, we initiated a comprehensive review of all Army nurse business and clinical processes and associated training and education. The gap analysis revealed a requirement for more advanced degree experienced nurses at patients’ bedsides to influence nursing care; specifically, to direct nursing care within a systems-based care delivery model that decreased nursing care variance across the Army Medical Department in order to measure and improve patient outcomes. To that end, we expanded our review to examine the new Doctor of Nursing Practice (DNP) role as a modality for closing the gap. After this review was completed, we recognized the value of placing select DNP’s within our NSCIs and the ANC is in the process of making this infrastructure change. This will provide clinical leadership, create a partnership with nurse Ph.D.’s and Nurse Method Analysts, and facilitate practical application of evidence-based research at the patient bedside to ensure evidence- based nursing care. According to the American Nursing Association (ANA), one of the most significant shifts in health policy is represented in a measure to expand the involvement and authority of advance practice nurses. Army Nursing is also working closely with na- 114 tional nursing organizations such as the American Academy of Colleges of Nursing (AACN) in leading national efforts to conceptualize a value-add role for DNPs as well as the new innovative clinical nurse leader role. The Army nursing SOC will require new capabilities while allowing us to better leverage current nursing capabilities. For example, nursing case management is increasingly being recognized as an essential component of healthcare delivery. Case managers provide added value to the multidisciplinary healthcare team. Case managers in Warrior Transition Units (WTUs) are providing care to over 9,000 Soldiers and have facilitated the transfer of over 8,500 Soldiers back to duty or on to become productive Veterans. Warrior satisfaction with case management services has remained at or above 92 percent throughout the year. The Army Nurse Case Management Course was fielded in December 2008. This course was designed to better prepare case managers in their role, facilitate the successful completion of national certification, and standardize case management services across WTUs, to ensure case managers are effectively trained to perform their mission. Over 300 nurse case managers participated in this web-based program that utilizes adult learning principles that enhance the Army NCM’s understanding of case management theory. Students learn about best practices across military and civilian settings, thus gaining knowledge of principles and tools utilized in case management. Army nursing case management is improving care in primary care settings as well as in our WTUs. Nurses across the country espouse success stories where case management has had a positive impact on patient care. In Alaska, NCMs were working with a 28 year old infantry Soldier undergoing the Medical Evaluation Board process for moderate Post-Traumatic Stress Disorder (PTSD). During one of their sessions they talked about his mother who died at age 34 with colon cancer. Because the case managers had developed a good rapport with the Soldier, he felt comfortable mentioning that he had some rectal bleeding. He was immediately evaluated, determined to have metastatic colon cancer, and underwent a colectomy. The operation saved his life. Subsequently, he was able to medically retire as a healthy, productive veteran. The strategic end state of this SOC is optimized nursing care delivery systems that wrap capability around AMEDD goals and priorities to achieve the best patient outcomes possible. This capability and functional structure is designed to leverage proliferation of evidence-based care and best practices to support TSG’s strategic objectives.

EVIDENCE-BASED PRACTICE: OPTIMIZE PERFORMANCE Our third strategic imperative is to optimize Army Nursing performance using evidence-based management and evidence-based clinical practice. Evidence-based clinical practice aims to merge best practices from both clinical care and business practices to produce optimal outcomes. These goals are achieved through scientific analysis, data management, and system redesign to support the everyday performance of all our nurses. For example, the Workload Management System for Nursing (WMSN) is a tool that ANC has been using for accurately measuring patient acuity in order to establish manpower requirements in our inpatient care settings. This past year, we initiated the most dramatic update to our WMSN since 1985. Led by talented Army Nurses, the WMSN Refresh and Optimization project will enable us to upgrade our WMSN operating system, integrate and migrate all previously separate servers, update the clinical classification and acuity measures, and develop a software interface for real time reporting tools. This milestone business process improvement will afford our nursing leadership the necessary data to support current and future resourcing decisions. Another example is the Clinical Information System (CIS) that was developed with input from our clinical and nursing informatics experts that has played a major role in modernizing our electronic health record. This past year included tremendous expansion of the CIS inpatient health record throughout the MEDCOM. The CIS is designed to help nurses and other healthcare personnel collect, record, store and access patient data, as well as data from medical instrumentation and physiologic monitors from a centralized computer system. The impact of a standardized inpatient nursing documentation system cannot be minimized as it not only provides standardized documentation of the patient’s history, but allows, through its requirement to enter data fields, standardization of how nurses practice. Another evidence-based initiative is our collaboration with the Veteran’s Health Administration (VHA) on Clinical Terminology Standardization that has resulted in the development of over 2,236 standardized clinical terms. The development of Sys- tematized Nomenclature of Medicine—Clinical Terms and Logical Observation Iden- 115 tifiers Names and Codes will allow for intra-operable standardized clinical vocabu- lary to assist both the providers, and the clinical researchers. Future collaboration will allow for a seamless process to add, review, and map new terminology and integrate this into DOD inpatient documentation systems. Given the magnitude of investment and the substantial military healthcare renovation and construction projects in the National Capital Region (NCR), it is important to examine the relationship between environmental evidence-based design (EBD) features and patient and staff outcomes. COL Petra Goodman, an Army Nurse (AN), has collaborated with investigators from numerous agencies, to include our sister services, military treatment facilities in the NCR and the DOD Patient Safety Center, to develop research protocols in EBD principles and their specific outcomes, including falls, work-related injuries, and hospital acquired infections. There series of studies will provide critical baseline information for future research in EBD. Implementing 2005 BRAC Law, Army Nurses have been involved from ‘‘Day One’’ in creating the new 1.23 million square foot Fort Belvoir Community Hospital ensuring that the project delivers on its mission to create a World Class Military Health Care facility. DeWitt Army Community Hospital (DACH) nurses, both uniformed and civilian, have provided critical input in the design, development, and implementation phases of this project which includes numerous EBD features such as single bed rooms with family zones, maximized use of natural light, healing gardens and positive distractions, increased HEPA filtration, ceiling mounted patient lifts, walled rather than cubicle spaces, and the use of reduced noise sources and sound absorbing materials. MAJ LaShanda Cobbs, AN, serving as Transition Director for the hospital project until July 2009, provided key leadership in coordinating design concept of operations workgroups, guiding utilization of EBD principles, and developing manning determinations for this state-of-the-art inpatient and ambulatory care center. Looking to the future, DACH nurses will continue to play pivotal roles in implementing integrated bedside IT solutions, the Vocera hands-free nurse call system, creating patient controlled environments utilizing Smart Room Technology, and myriad other operational solutions to maximize EBD features to minimize hospital acquired infections and increase patient safety. Never before have we relied so heavily on nursing research to infuse nursing practice with evidence-based science. In February 2009, the Triservice Nursing Research Program (TSNRP) invited nurse scientists from all services to meet in order to determine new priorities for TSNRP. Not surprisingly, Force Health Protection was recognized as the number one priority. Deployment research is designed to ask critical questions that cannot be answered other than on the battlefield providing medical care for our service members. Army nurses have led the way with deployment research relative to their strong presence in field environments. There have been 34 nursing led protocols, 27 of those are from ANC researchers and one joint Army/ Air Force protocol. A breakdown of these protocols includes a total of 20 protocols on warrior care, including five on Soldier Health, three on Trauma care, and one on Behavioral Health and a total of 14 protocols to study the impact of compassion fatigue and stress on nursing and healthcare professionals. Post Traumatic Stress Disorder (PTSD) is a focal point for many of the studies. COL Kathy Gaylord at the Army’s Institute of Surgical Research is conducting three studies to evaluate alternative therapies for treatment of PTSD or PTSD symptoms in burn patients. ‘‘Grad- ual Virtual Reality exposure therapy and D-Cycloserine (a learning enhancer pill) treatment for combat-related PTSD’’ is a pilot study to determine the effectiveness of virtual reality therapy for service members who have sustained a burn injury requiring multiple dressing changes as a distraction to reduce their pain during these dressing changes. ‘‘Cranial Electrotherapy Stimulation (CES) on PTSD Symptoms in Burned Outpatients’’ is a double-blind randomized control research study is to determine if CES given to service members who have sustained a burn injury and meet PTSD criteria will be effective to reduce their PTSD symptoms and other deployment-related symptoms. ANC research scientists also continue to collaborate with the other DOD agencies, the Department of Veterans Affairs, and universities in support of the congressionally funded studies for research. In the Pacific region, Army nurses established a clinical-academic research partnership between Pacific Regional Medical Command (PRMC) and the University of Hawaii. This first formal academic-clinical nursing research partnership between Tripler Army Medical Cen- ter and the University of Hawaii creates a joint vision for the future of nursing and healthcare. This partnership provides the resources and structure that will allow Pacific Regional Medical Command (PRMC)-based nurses and University of Hawaii (UH)-based nurses to ask and answer the clinically relevant military healthcare questions. 116

Army Nurses, like MAJ Rebecca Terwilliger, are leading the way with an innovative best clinical practice pilot to improve nursing care. She won a $17,532 grant from the March of Dimes to establish a Centering Pregnancy Program for antepartum patients. Participants enroll into a stable group that begins meeting at 16 weeks followed by monthly meetings until 32 weeks, then every other week for the remainder of the pregnancy. The group meets for 2 hours each session and is led by a certified nurse midwife. Benefits of the program include the development of a socialization and support network system while providing 2 hours of education on topics related to pregnancy, childbirth and newborn care. Evidence has shown that the program increases patient satisfaction, increases continuity with a provider and decreases preterm birth rate; for those that deliver prematurely, delivery occurs in gestation and the newborn is at a higher birth weight. Research is also supporting evidence-based business practices. For example, we used data to evaluate our accession portals and make timely changes on how we recruit, retain, and incentivize nursing personnel to remain a part of our nursing team. The Army Nurse Corps was very successful in recruiting and retaining Army Nurses in 2009. Research, like that being done by LTC Breckenridge-Sproat, AN, titled ‘‘Factors Associated with Retention of Army, Air Force, and Navy Nurses’’ will survey Active Duty Army, Navy and Air Force nurses to explore factors influencing decisions to maintain their active duty status. In the history of military nursing research, there has never been a retention survey using a validated instrument conducted across all three services. Considering the changing market for registered nurses in the United States and the complex factors that influence decisions to remain on active duty, it is important to obtain data to support appropriate strategies to retain military nurses in the Army, Navy and Air Force. The results of this multi- service study will provide the Corps Chiefs from the Army, Navy, and Air Force with a better understanding of factors impacting nurses’ intent to stay in the military. The findings should allow administrators to capitalize on specific factors that positively influence nurses to stay in the military and implement changes to amelio- rate factors that are influencing nurses to leave the military. Research is also helping us develop new recruiting strategies, called precision recruiting, whereby we are recruiting experienced medical-surgical and specialty trained nurses. This strategy will provide us with a balanced force of new nurse graduates with more experienced clinical nurses. Leveraging data allowed us to determine the need for precision recruiting, i.e., targeted recruiting of critical low densities. As a result, we increased our recruitment of Nurse Anesthetists, Behavioral Health Nurse Practitioners, Family Health Nurse Practitioners, and critical skills such as Emergency Room and Critical Care trained nursing personnel. These skills are especially in high demand with our nation’s continued involvement in overseas contingency operations. Working closely with Accessions Command, we are formu- lating a recruitment strategy that ensures a consistent pipeline of ROTC, Army En- listed Commissioning Program (AECP), and Federal Nurse Commissioning Program graduates, balanced with direct accessions of experienced nursing personnel. Evidence-based processes also allow us to look at who, when, and where we have the greatest attrition and how attrition is impacting the care we provide for our beneficiaries. Incentives, such as Incentive Special Pay, critical skills bonuses, and hiring bonuses have not only allowed us to conduct precision hiring of civilian nurses, but also allowed us to compete with the recruitment market for experienced and well qualified nursing personnel. I want to thank the committee for supporting these initiatives in the past and look forward to your continuing support in the future. In addition we raised and then codified minimum standards for entry into the AECP based on the quality of the nurses this program produces. In the past we have had as high as 14 percent non-completions in the AECP. Data analysis revealed an antiquated admission criteria resulting in candidates who were not adequately prepared to sustain the rigors of the Bachelor’s of Science program. The change in admission standards has vastly improved the quality of candidates in the program and will ultimately impact the quality of care we will provide to our warriors and their families.

HUMAN CAPITAL: PORTFOLIO OF TALENT People are our organizations’ most valuable asset and remain one of my top priorities. Success toward our strategic initiatives has been possible only because of the commitment and extraordinary work by the triad of nursing; Active and Reserve component officers, non-commissioned officers, and civilians. Our efforts over the past year in both recruitment and retention of active duty and civilian nurses have positively impacted Army Nursing. Investing in human capital requires a strategic approach to managing the recruited and retained talent so patient outcomes are op- 117 timized throughout the organization. Subsequently, our fourth imperative is optimizing human capital talent through talent management and succession management planning. One of the ways we are managing talent is by leveraging nursing capability in new ways. A great example of this is the ‘‘curbside nursing’’ concept that clinical nurse midwives implemented at Fort Campbell, KY. In 2009, it became strategically imperative that some type of new Soldiers’ health initiative for women’s gynecological intervention and engagement was needed to address the backlog of gynecologic appointments. Several Certified Nurse Midwives (CNM) services have actively engaged in leaving the confines of the hospitals and entered what normally has been recognized as a Soldier’s clinic. This medical model approach to women’s wellness has received laudatory comments noted in Army Provider Level Satisfac- tion Survey reports across several installations. To support TSG’s strategic priority of implementing a comprehensive behavioral health system of care, BG Steve Jones, Commander, Pacific Regional Medical Com- mand, and I worked together to implement a program to assess the effectiveness of connecting behavioral health resources with soldiers in a virtual encounter. Nurs- ing resources were engaged in validation of the assessment tool as well as serving as a force multiplier through the integration of NCM and 68X, Mental Health Tech- nicians, in the virtual program. Partnered with behavioral health (BH) providers, NCM screen for ‘‘at risk’’ Soldiers face-to-face and virtually with the intent to provide access to BH in remote or isolated locations. Many Soldiers returning from deployment do not need the complex services of the Warrior Transition Unit (WTU), but they do have significant concerns that could impact successful reintegration with families and non-combat environments. Coordinating care and support through the NCM, Soldiers and families are guided to financial, emotional, and physical care to support reintegration. The NCM effort in this Comprehensive Behavioral Health System, led by Amy Earle, RN, mitigates stressors to the Soldier and family by connecting them to services within the community. At Europe Regional Medical Command, the Maternal Child Nursing section uses a Perinatal Clinical Nurse Specialist to track high risk patients, which resulted in significantly increasing the number of infants that were immunized against Hepa- titis-B at birth or prior to discharge as recommended by the Centers for Disease Control. In 2009, LTC Sherri Franklin, Chief of Nurse Midwifery, started a new midwifery program with 3 active duty CNMs at Fort Benning, Georgia. Due to the increased demand for low risk obstetrical care and the size of the post increasing, this planned service will be stabilized at Benning. Planned for 2011, an additional 6 new CNM graduates from accredited mastered prepared programs across the United States will be welcomed as new clinicians. This year, for the first time in our history, two of the deployed Combat Support Hospitals will be commanded by Army Nurse Corps officers. In 2009, 333 active duty Army Nurses were deployed in support of Operation Iraqi Freedom and Oper- ation Enduring Freedom. This represented a total of 70,589 deployed man days. In 2009, the 6 month (180 days) PROFIS deployment policy was successfully implemented, considerably reducing the adverse affects of long deployments on our nursing personnel. Through the expert coordination of our nursing leaders, nursing staff were rotated at 6 month intervals with no adverse impacts in patient care. However, our low density nurse specialists, to include nurse anesthetists, nurse practitioners, critical care, perioperative and emergency nursing are still experiencing frequent deployments with some nurses completing their second and third deployments. We are conducting an in-depth force structure analysis to determine our objective force structure for the future years. Our Budgeted End Strength is projected to increase from 3,515 in fiscal year 2010 to 3,580 in fiscal year 2011. In addition, 80 Army Nurse Corps officer authorizations are projected as a part of the Grow the Army strategy. We are modeling for the optimal number of critical care nurses, emergency room nurses and behavioral health nurses needed to ensure sufficient staffing in our CONUS based medical treatment facilities and to continue the theater support that has supported the 93 percent survival rate of our service members injured in our combat theaters. We recognized that many of our specialty nurses transition to advanced practice roles as nurse anesthetists or nurse practitioners but their ‘‘loss’’ from the specialty role was not included in our previous models. Using innovative analytical processes we have identified shortfalls in our training requirements that, when corrected, will increase the available strength of these critical low density nurse specialists. With increased numbers, the adverse impact of frequent repeat deployments will be mitigated. The Army Nurse Corps has always been committed to advanced education as an essential element of quality healthcare. As we face the continuing behavioral health challenges, we are increasing our number of nurses selected for behavioral health nurse practitioner programs. Of note, only the Psychiatrist and the Behavioral Health 118

Nurse Practitioner has prescriptive authority as Behavioral Health providers. We have recognized that this level of Behavioral Health providers is critical in both garrison and deployed settings to facilitate optimal behavioral healthcare. This year, we will select 5 nurses for attendance in the Psychiatric/Mental health NP program at Uniformed Services University (USU) to start in 2011. In addition, as we transition our advanced practice nurse roles to the future DNP, we will be sending one nurse for a DNP program as a Psychiatric/Mental Health NP. We rely on the USU Graduate School of Nursing as the strongest educational platform to develop critical talent to provide nursing capability across Army Medi- cine. A good example of how USU is helping us build new nursing capabilities is the perioperative nursing program. COL (R) Wanzer and LCDR Conrardy, USU nursing faculty, developed a perioperative CNS program marketing brochure and designed a marketing poster for presentation at the 11th Annual Tri-Service Perioperative Symposium in Chicago in March 2009, and along with her fellow researchers Cole Hawker and D. Moultrie, were awarded the 2009 Association of Perioperative Registered Nurses National Research Excellence Award for their research titled: ‘‘Factors Associated with Multidrug Resistant (MDR) Acinetobacter Transmission Occurring in Traumatic War Injuries’’. COL (R) Wanzer was also invited to address Congress during hearings on healthcare reform and presented ‘‘The Role of Clinical Nurse Specialist in Health Care Delivery: Today and in the Future.’’ The Psychiatric Mental Health-Nurse Practitioner (PMH–NP) Program was evaluated for its academic content, testing, and overall effectiveness. Changes have been made to the course structure in order to ensure students integrate and apply their knowledge in context of the goals of the program. In addition the Graduate School has signed eleven new memorandums of understandings with new clinical sites. In October 2008, USU chartered a task force to examine implementation of a DNP curriculum to be in line with the American Association of Colleges of Nursing decision to move the current level of preparation necessary for advanced practice nursing from the master’s to doctoral level by the year 2015. The results of 8 months of study revealed that USU should take the steps necessary to implement a USU DNP program. This further expands USU’s strength as an education platform for Army Nursing so that we can apply a practical application of evidence-based research at the patient bedside to ensure evidence-based nursing care. Over 60 percent of our organization is our civilian workforce, so our retention efforts continue to be focused on this group. We continue to have unprecedented success in our civilian nurse loan repayment program, with over 41 percent of total Army student loan repayments going to nurses. For fiscal year 2010, 314 applicants were selected to participate in the nurse loan repayment program, the largest number since the program started in 2006. We also recognize that our talented civilian healthcare professionals have unique issues and challenges. To provide support to our civilian nurse workforce, the Civilian Nurse Task Force was chartered in March 2009 to provide a forum for specific discussion on issues related to recruitment, retention, and career progression. This group’s hard work resulted in the adoption of a civilian RN career pathway that remains in a working phase today. From this task force, a Nurse Consortium was established, in November 2009, and each medical treatment facility has a civilian nurse representative. This consortium works on key issues affecting satisfaction of the civilian nurse workforce. Current working issues include improving the relationship between civilian and military nurses, recruitment of civilian new graduate nurses, and civilian nurses in senior leadership positions in medical treatment facilities. Our first step to leverage civilian nurse talent at the senior executive level was the selection of Dr. Patricia Wilhem as a member of the Army Nurse Corps Executive Board of Directors. In addition, the ‘‘Civilian Connection’’ link was established on our new, innovative ANC website and is used to post links and information pertaining to civilian nurses. It facilitates a sharing of information not only between civilian nurses but also between civilian and military nurses to enhance professional relationships. Finally we continue to leverage our retired ANC officers to serve as nurse role models, mentors and subject matter experts and ambassadors for the ANC. COL (R) Jeri Graham, president of the Army Nurse Corps Association (ANCA) in partnership with the ANC conducted the pilot Veteran’s Resiliency Program in May 2009. There were sixteen participants with eleven active component combat veteran nurses and five Vietnam veteran nurses. The program was designed to address the issues that returning warrior nurses have after deployment that impact retention. The program was received favorably and with many positive comments to sustain the program in the future. 119

CONCLUSION There has been great momentum since I introduced the Army Nurse Corps Cam- paign Plan to you last year. Our success has been the result of compassion, commitment, and dedication from all members of the triad of nursing. They have inspired me with their pride, enthusiasm, and openness to change. We continue to experience amazing progress in each of our strategic imperatives and we are ensuring that the ANC remains relevant and a force multiplier for Army Medicine. I continue to envision an Army Nurse Corps in 2012 that will leave its mark on military nursing and will be a leader of nursing practice reform at the national level. The implementation of the standardized Patient & Family Centered System of Care is revolutionizing nursing care in the ANC and ensures that we optimize patient outcomes at every point of care delivery, both home and abroad. It reminds us that our priorities remain the patients and their families. Our common purpose is to support and maintain a system of health. In order to achieve this common purpose, we will let nothing hinder those who wear the cloth of our Nation or those who took an oath to forever save, protect, care, and heal.

PREPARED STATEMENT OF REAR ADMIRAL KAREN A. FLAHERTY

INTRODUCTION Good Morning. Chairman Inouye, Senator Cochran and distinguished members of the subcommittee, I am Rear Admiral Karen Flaherty, the 22nd Director of the Navy Nurse Corps. Thank you for the opportunity to speak to you today. I also want to express my sincere thanks and appreciation for the hard work and dedication of Rear Admiral Christine Bruzek-Kohler, the 21st Director of the Navy Nurse Corps during this past year. In his 2009–2010 Chairman, Joint Chiefs of Staff Guidance, Admiral Mullen declared the ‘‘Health of the Force’’ as one of his three strategic initiatives, stating, ‘‘Our core responsibility is to win wars while caring for our people and their families. They are the heart and soul of our formations, our fleets, and our air expeditionary wings, and our incredible fighting spirit. As a Nation, we have a solemn obligation to fully support, across the spectrum of need, our service men and women, standing and fallen, and their families.’’ Today, I will highlight the accomplishments and opportunities facing the Navy Nurse Corps in 2010 as we care for the Health of the Force. The total Navy Nurse Corps, comprised of Active, Reserve and Federal Civilian nurses, number more than 5,500 strong. Working together, we are clinicians and advocates for our patients, we are mentors and leaders for our colleagues, and we are the face of caring and compassion to those affected by armed conflict and natural disasters. My strategy as Director has been focused in three areas: People, Practice and Leadership. It is within these three areas that I would like to highlight our successes and address our current and future efforts.

OUR PEOPLE Recruitment Today’s Navy Nurse Corps Active Component (AC) is manned at 91.2 percent with 2,837 nurses currently serving around the world. We have already achieved Navy Nursing’s Active Component recruiting goal for 2010, for the fourth consecutive year. Reserve Component (RC) recruiting is currently at 16.4 percent of the fiscal year 2010 mission and requires our continued focus. I attribute our recruiting successes to the continued funding support for our accession programs, the local recruiting activities of Navy Recruiters and Navy Nurses, and the continued positive public perception of Service to our Country. The top three direct accession programs that are favorably impacting our recruiting efforts include the Nurse Accession Bonus (NAB), the Health Professions Loan Repayment Program (HPLRP), and the Nurse Candidate Program (NCP). The NAB continues to offer a $20,000 sign-on bonus for a 3-year commitment and $30,000 for a 4-year commitment; the HPLRP repays student loans up to $40,000 for a 2-year consecutive obligated service, and NCP, tailored for students who need financial assistance while attending school, provides a $10,000 sign-on bonus and $1,000 monthly stipend. In 2008, Navy Medicine created a recruiting team aimed at increasing the visibility and focus on Navy Nursing recruiting initiatives. This effort provides a Navy Nursing presence at local and national professional nursing conferences and colle- giate recruiting events. In collaboration with the Navy Medicine Office of Diversity, 120 our Nurse Corps Recruitment Liaison Officer coordinates with local Military Treat- ment Facilities (MTFs) to have diverse Navy personnel attend national conferences and recruiting, increasing Navy’s visibility among minority populations. This has allowed us to broaden our reach, and participate in and recruit across a broad range of national nursing conferences. Further, recognizing that America’s youth contemplate career choices at a young age, Navy Nurses travel to local community schools and serve as guest speakers and ambassadors for our Corps, the Navy and the nursing profession. Leveraging current technology, the Nurse Corps Recruitment Liaison Officer uses a combination of social networking media tools, including Facebook and Twitter, and online discussion forums (e.g., BLOGs), to reach students at colleges and high schools, encouraging them to consider a career in Navy nursing. Through these media tools, students ask candid questions and can obtain instant feedback in a mode of communication with which they are comfortable. Additionally, students provide feedback of what is and is not working in the recruiting process. Using this information, we have implemented process improvement strategies to correct any gaps in the recruiting process. One improvement we are implementing in 2010 is an early mentorship program for those entering the Navy Nurse Corps through one of our accession programs. Junior nurses will serve as mentors to guide new accessions from school to their first duty station, providing information on pay, travel, duty stations and transition to ‘‘Navy Life.’’ We know that the first impression of the Navy and the Navy Nurse Corps are an important part of subsequent career decisions. Today, the Reserve Component is 83.6 percent manned with 1,112 nurses in inventory. Last year, the Navy Nurse Corps Reserve Component (RC) met 87 percent of their recruiting goal. Over 48 percent of the accessions were Navy Veterans (NAVETS—nurses coming to the RC from active duty) with the remainder joining the Navy Reserve as direct accessions. Success in recruiting NAVETS is related to the initiation of an affiliation bonus of $10,000 and a policy that guarantees these individuals a 2-year deferment from deployment. Additionally, the establishment of the Career Transition Office (CTO) at Navy Personnel Command has been very successful in identifying those members desiring to move from the active component to the reserve component. The CTO, working in concert with the Reserve Affairs Offi- cer (RAO) and Centralized Credentialing and Privileging Department (CCPD), implemented practices that facilitate a smooth transition with regards to billet assignment, pay and establishment of credentials. Our reserve recruiting goal for fiscal year 2010 is 165 nurses. A recruiting initiative targeting direct accessions will offer entry grade credit for advanced education and work experience among the critical wartime specialties of Certified Registered Nurse Anesthetists (CRNAs), psychiatric/mental health, emergency room, and perioperative nursing. These initiatives will be expanded to include medical-surgical nurses and critical care nurses as well. Retention Retaining Navy Nurses is one of my top priorities. We remain committed to providing a Total Force of Navy Nurses, balanced in terms of seniority, experience, and skills, to provide the very best care to Sailors, Marines and their families. Key efforts have positively impacted retention, including the Registered Nurse Incentive Specialty Pay, a targeted bonus program for undermanned clinical nursing specialties and highly deployed Nurse Practitioners. Our nurses are enriched by being able to practice in both deployed and garrison care settings. It is our responsibility as Nurse Corps leaders to fully understand all retention issues. We commissioned the Center for Naval Analyses (CNA) in 2009 to conduct a survey and hold focus groups to help us understand the factors that influence career satisfaction and dissatisfaction in the Nurse Corps. We have found that support for families, childcare availability, healthcare, and other benefits such as the Post 9/11 GI Bill play an important role in nurse retention. Navy Nurses told us they wanted a clinical career ladder. Junior nurses felt they had to leave clinical nursing in order to advance in their careers. They also told us that deployments were fulfilling and had a positive affect on retention. The factors affecting retention are described more as a ‘‘pull’’ away from the military versus a ‘‘push’’ out of the military. To increase promotion opportunities for senior level positions, we converted a portion of vacant Lieutenant billets to Captain and Ensign billets. These actions also improved the alignment of billets with the number of junior officers being accessed each year. This right-sizing is also occurring for the Reserve Component led by Rear Admiral Cindy Dullea, my Reserve Component Deputy Director. The RC is challenged with personnel gaps in the junior ranks and a larger senior officer force. 121

These initiatives will ensure we maintain an appropriate balance of highly-skilled experienced nurses with promotion opportunities. My goal for this year is to increase retention by 50 percent in the AC for those with less than 10 years of service, and to retain the appropriate numbers in each officer rank in the RC. To achieve this goal, we are increasing communication and mentoring across all ranks, developing a clinical leadership model, and creating a user-friendly job-assignments process focused on clinical specialty development. Most importantly, I have asked each Nurse Corps officer to be part of this strategy; people stay in organizations because of the positive influence of their peers and immediate supervisors.

OUR PRACTICE Clinical Excellence Clinical Excellence is one of the main tenets of the Nurse Corps Clinical Leader- ship Model. Our strategy prepares every nurse to practice safe, competent care in any clinical setting, whether in a hospital or clinic, onboard ship or in forward deployed settings. Clinical Excellence is an expectation of the patients we care for and is an integral part of the interdisciplinary healthcare team of Navy Medicine. In 2009, we developed and implemented standardized orientation and nursing competencies across all of our nursing specialties. This creates portability, efficiency and consistency of care across all environments. Our goal is to deploy an electronic standardized procedure manual in 2010 for all facilities to have real time access to state-of-the-art updates to clinical care. Over the past several years, the Nurse Corps identified eight critical wartime specialties, and developed our manning, training and bonus structures to incentivize nurses to practice within these specialties. Additionally, each Nursing Specialty has an assigned Specialty Leader, a Clinical Subject Matter Expert who understands the nursing practice within each community. These Specialty Leaders are key in the sourcing process for deployment missions, and have been empowered to implement improvement strategies for their specialty communities. Understanding deployments and the type of care needed by our patients is essential when developing our nurses. For example, the critical care patient in Afghani- stan may be required to stay on the ground longer given the environmental challenges impacting medical airlift evacuation. Our staff needs to understand this and add to their portfolio of skills in both acute and chronic critical care nursing competencies. To accomplish this goal, our Specialty Leaders worked with Senior Nurse Leaders at MTFs to create partnerships with local civilian hospitals and military nurses cross-train in local Emergency Departments and Intensive Care Units (ICUs). All Navy Nurses deploying in a critical care role cross-train in an ICU and attend the Essentials of Critical Care Orientation Course, the industry standard for critical care orientation. We are also piloting a ‘‘closed-loop’’ detailing process where nurses who desire to practice in the critical care specialty for their careers, have the ability to be transferred to hospitals that provide critical care nursing. Our goal is to keep these highly-trained critical care nurses working in critical care. To support the behavioral health needs of our Warriors and their families, the Nurse Corps has increased its inventory of psychiatric/mental health clinical nurse specialists and nurse practitioners. This growth will support the projected growth of the Marine Corps, Blue in Support of Green (BISOG) and the increase in the number of Operational Stress Control and Readiness (OSCAR) teams. We have successfully employed Psychiatric-Mental Health Clinical Nurse Specialists and Mental Health Nurse Practitioners to meet the operational demands of the Psychiatric-Men- tal health caseload. Looking ahead, we will align our core privileging with our civilian counterparts, deploy mental health nursing assets where needed, and increase the education pipeline to meet this requirement. Senior Nurses empower their staffs to innovate in hospital, clinic and operational settings, ensuring a culture of clinical excellence is infused at all levels. An example of these innovations is a job sharing initiative in USNH Guam, where two nurses can gain leadership experience, while continuing to excel as clinicians. A Family Nurse Practitioner in Okinawa, created efficiencies, eliminated patient visit back- logs, and increased family satisfaction while maintaining family-centered care. He established a Fast-Track clinic that resulted in a 25 percent decrease in non-urgent care provided by the Emergency Department. Through Clinical Excellence in Prac- tice, our nurses gain the confidence and competencies to ensure that Navy Medicine remains a leader in healthcare. 122

Nursing Education I am a fervent supporter of graduate nursing education, research and professional growth of my officers, and am committed to the sustainment and growth of the Tri- Service Nursing Research Program (TSNRP). Each year, approximately 73 officers are selected for Duty Under Instruction, the Nurse Corps’ graduate education program. Additionally, nurses are selected to participate in the Johnson and Johnson Wharton Fellow’s Program in Management at the University of Pennsylvania, and several Navy-sponsored leadership courses. Clinical specialization matched with leadership experience is key to developing the clinical leader. The American Association of Colleges of Nursing made the decision to move the current level of preparation necessary for advanced nursing practice from the master’s degree to the doctorate-level by 2015 based upon shifting patient demographics, health needs, and changing health system expectations. The Navy Nurse Corps supports a phased approach toward adopting the Doctorate of Nursing Practice (DNP) as the recommended terminal degree for Advanced Practice Nurses, and will utilize a combination of short- and long-term action steps to incorporate the DNP degree option as part of its education strategy. Using existing funding, three nurses will graduate with a DNP in 2012 and the DNP degree will be incorporated into the Nurse Corps Training Plan. As we make the transition to a greater number of DNPs, we will conduct careful reviews of future education funding requirements. To expand this clinical leadership model to Federal Civilian Registered Nurses, we launched the Navy Graduate Program for Federal Civilian Registered Nurses, the first of its kind in the Uniformed Services, and funded five competitively selected Federal civilian registered nurses to pursue their Master of Science in Nurs- ing degrees. These selected candidates agreed to work a compressed work schedule during the time they are in graduate school and incur a 2-year continued service agreement. This program has been fully funded in 2010, and we are currently receiving applications to select our next class of candidates for Fall 2010. We expect that this new program will retain our current civilian nurses, incentivize new nurses to consider entry into Federal service, sustain Military Treatment Facilities with subject matter experts when military nurses are deployed, and offer new educational growth for our civilian colleagues. Every military nurse joins the Service with a Baccalaureate degree or higher, thus our Nurse Corps education strategy is focused on Graduate Nursing Education. I thank you for your support of this critical strategy. Nursing Research Navy Nurse Researchers assigned to Medical Centers educate nurses, physician residents, faculty, and staff about research design, implementation and evaluation. They facilitate the research process though collaboration with the Nursing Research team, Clinical Investigations and local, national and international academic institutions. More than 15 formal studies are in progress to promote the health and wellness of our Warriors and their families. Additionally, several evidence-based practice projects underway synthesize research literature to create individual evidence-based nursing practice guidelines and ensure practice effectiveness. The ‘‘Back-to-Basics Bundle of Care Project’’ at Naval Medical Center San Diego and the ‘‘Electronic Ticket-to-Ride, a Standardized Hand-off Program’’ at National Naval Medical Center are just two examples of research projects that will increase patient safety and satisfaction, increase efficiency, decrease healthcare costs, and promote positive health outcomes during inpatient stays. Navy Nurses are accomplished authors, presenters and leaders not only in the field of Nursing, but also in healthcare and medicine. Many have contributed to military, national and international forums as keynote speakers and subject matter experts. Captains Linnea Axman, NC, USN and Patricia Kelley, NC, USN were members of the planning committee for the 2009 Botswana Conference. This conference, co-sponsored by Navy Medicine and Uniformed Services University, identified opportunities for the development of collaborative international research proposals and advancement of the concepts of integrity in research. Commander Michele Kane, NC, USN was the first Nurse Corps officer to provide the keynote address at the 2009 World Congress on Military Medicine. The research conducted by these outstanding nurses is a testament to their expertise, scholarship and commitment to advancing scientific knowledge in the field of medicine. Among the many nationally recognized award winners for Navy Nurses, Lieuten- ant Colleen Mahon, NC, USN was recognized as the National Association of Wom- en’s Health Obstetric and Neonatal Nursing’s Navy Nurse of the Year, and Com- mander John Maye, NC, USN was selected as the American Academy of Nurse An- esthetists’ Researcher of the Year. 123

Outreach and Partnerships Navy Nurses, at our MTFs in the United States and abroad, passionately support the professional development of America’s future nursing workforce by serving as preceptors, teachers and mentors for local colleges and universities, as well as entire health systems. During Continuing Promise 2009, Navy Nurse Corps officers from the USNS Comfort served as subject matter experts providing training in Advanced Cardiac Life Support, Basic Life Support, IV insertion, basic first aid, trauma care, EKG interpretation and basic nutrition to 35,000 host nation medical personnel. Al- though a U.S. Navy mission, Nurses worked with partners from the Active Compo- nent, Reserve Component, Army, Air Force, U.S. Public Health Service, and over 90 nurse volunteers from Project Hope, the Church of Latter Day Saints, and Oper- ation Smile. Additionally, over 40 military nurses from Canada, El Salvador, Neth- erlands, and France worked side-by-side with us in providing care to over 100,000 patients. Today, the USNS Comfort is deployed staffed by caring colleagues providing humanitarian assistance to the people of Haiti. Navy Nurses deployed to Afghanistan in embedded training teams are teaching culturally and linguistically appropriate public health measures. In response to news of H1N1 outbreaks throughout the world, nurses prepared emergency response plans and training for the local Forward Operating Base (FOB) and Regional Hos- pital in eastern Afghanistan, well in advance of cases appearing in-theater, and deployed critical counterinsurgency tactics by performing village medical outreaches to the local community members in eastern Afghanistan. These missions improved relationships, increased trust and fostered cooperation with U.S. and coalition forces among the local population.

OUR LEADERSHIP I believe that leadership at all organizational levels is responsible for ensuring the personnel under their charge are healthy and productive. This is echoed by Admiral Mullen, ‘‘As leaders, we must ensure that all receive the care, counseling, training and financial support to become self-sufficient and lead productive and fulfilling lives’’ (CJCS Guidance, December 2009). My nursing leaders have developed and are implementing an interactive career planning guide useful for mentoring seniors and subordinates at every stage of their careers. This mentoring tool asks pointed self- assessment questions to the officer and the nurse leader to assist both in making the best professional career decisions balanced with professional and personal goals. It guides the nurse leader in assessing the strengths and needs of the officer and balancing them with organizational goals. Blending our officers’ clinical excellence, operational experience and leadership develops the highest caliber leaders for Navy Medicine today and in the future. Each nurse is a leader, whether caring for a population of patients, leading a Command, or being the Nursing voice for our Fleet or our Marines. Each day, we have an opportunity to impact the health and well-being of others. A key role of a leader is to know their people and help them develop the resiliency to be able to handle stressors and life events. Navy Medicine’s Operational Stress Control and Care for the Caregiver programs have a direct impact on the health and well-being of the force, deployment readiness and retention. By developing and providing education and training opportunities throughout the service member’s career, Operational Stress Control builds resilience and increases effective responses to stress and stress-related injuries and illnesses. We know that caring for service members and their families and experiencing the trauma and stress that they experience can impact our medical staff. Strengthening the resilience of our Navy Nurses will assure they are better equipped to meet the day-to-day challenges of both naval service and their profession.

CLOSING REMARKS Thank you for providing me this opportunity to share with you the remarkable accomplishments of the Navy’s Nurse Corps and our continuing efforts to meet Navy Medicine’s mission. On behalf of the outstanding men and women of the Navy Nurse Corps, and their families who faithfully support them, I want to extent my sincere appreciation for your unwavering support.

PREPARED STATEMENT OF MAJOR GENERAL KIMBERLY A. SINISCALCHI The Total Nursing Force (TNF) is comprised of our officer and enlisted nursing personnel including the Active Duty (AD), Air National Guard (ANG), and Air Force Reserve Command (AFRC) components. It is a pleasure to lead and serve alongside 124 my senior advisors, Brigadier General Catherine Lutz of the ANG and Colonel Anne Manly of the AFRC. Together, we command a total force team delivering evidence- based, patient-centered care and support to meet Global Operations. Our nursing service personnel confront the challenges of increasing commitments and deployments with distinction and professionalism. They support the top priorities of the Secretary and the Chief of Staff of the Air Force to: (1) Continue to Strengthen the Air Force Nuclear Enterprise, (2) Partner with the Joint and Coalition Team to Win Today’s Fight, (3) Develop and Care for Airmen and their Families, (4) Modernize our Aging Air & Space Inventories, Organizations & Training, and (5) Recapture Ac- quisition Excellence. This testimony will reflect how Air Force Nurses, lead, partner, and care every time and everywhere.

EXPEDITIONARY NURSING Operational capability, the foundation and moral fiber of Air Force nursing, is instrumental in driving remarkable achievements. Air Force nurses and medical technicians at Craig Joint Theater Hospital (CJTH) at Bagram Airfield, Afghanistan provided outstanding nursing care for the highest number of casualties in OEF. CJTH is the only total U.S. staffed Level III military treatment facility in Afghani- stan, and offers the most advanced medical capability in the country. CJTH nurses functioned as preceptors for nine Afghan nurses embedded as part of an Afghan Trauma Mentorship program. The Afghan nurses worked side-by-side with Air Force nurses and medical technicians, gaining valuable clinical experience, which they are excited to share with their co-workers to create positive change for the Af- ghan healthcare system for years to come. The summer and fall of 2009 at CJTH is summarized through excerpts written by Dr. Zeriold, the ‘‘trauma czar’’, of his time in Afghanistan. ‘‘A conflict that had become known as ‘The Forgotten War’ was suddenly remembered as we entered the Afghan theater. We found a hospital and system in existence for several years that had seen a moderate number of patients. We brought only ourselves; it was a team from all over the United States from all branches of the military. No extra equipment, no new technology, no more medications, gear, or personnel. We were the standard deployment team for this theater. However, the pattern of this war changed. Over the next 6 months, we took care of more than 1,000 trauma admissions and countless medical admissions. The acuity was very high, and injuries were horrendous. A new pattern of war trauma had emerged for this hospital, a pattern that rivals and even surpasses a 500 bed, university based, Level I trauma center. We safely returned to the states 550 injured U.S. service members. We returned them to their families, children, and spouses. We changed the devastated lives of 450 Afghan nationals and won their hearts. I will never forget the bonds we formed with so many. And the kids—my God, I will never forget the kids; reaching out their little hands, with a smile, at the time of discharge as if to say thank you, ‘I’ll be okay, and can I go home now?’ As a result of your dedication and work, this hospital and this team set the theater standard, and broke theater records for caseload, admissions, transfers, and outcomes. We transformed this time, mid to late 2009, into an era never to be forgotten.’’ CJTH also functions as the primary theater Aeromedical Evacuation (AE) hub, for out of country casualty transport. The Contingency Aeromedical Staging Facility at Bagram facilitated an average of 500 patient movements per month, starting July 2009. ‘‘They are the ‘Angels of the Battlefield’—medics dedicated to transporting wounded U.S. and coalition service members, as well as locals, to the medical care they need. It’s our job to take care of these wounded warriors,’’ said Maj. Dawn Rice, an Air Force Reserve flight nurse and medical crew director assigned to the 451st Aeromedical Evacuation Squadron (AES). ‘‘We take great pride in getting people the top-notch care they deserve. Our country and our military will do whatever it takes to get people to the appropriate medical facilities. We want people to know this,’’ she added. ‘‘Hopefully, it will give them some comfort when they are outside the wire fighting the enemy.’’ Air evacuation is a detailed process with the aircrew acting as the most visible link in the chain. The process typically begins at a local level. ‘‘The primary mission at smaller field hospitals is simply stabilizing the patient,’’ said Chief Master Ser- geant John Trujillo, 451st AES superintendent. ‘‘Once the patient is stabilized and can be moved to another more capable hospital, then it’s our job to get them there.’’ While caring for wounded service members is the crew’s primary mission, they provide the same level of dedication to all. The squadron recently flew a 9 year-old Afghan girl and her 13 year-old brother from a major hospital at Bagram Airfield to a base in Southern Afghanistan. She had been at the hospital at Bagram for 2 months recovering from injuries received during a mortar attack on her village. 125

Prior to the United States stepping in, her brother had been tasked with her care, replacing bandages on her legs and overseeing her well-being. As she was brought aboard the aircraft for her flight, nurses from Bagram said their tearful goodbyes while crewmembers gave the children gifts and treats, bringing out their smiles. Looking at the children, the Major spoke about this moment and how it transcended geographical borders and political differences. It was truly a moment of human compassion. The care being given was not just between Americans and Afghans, or adults and children, but between human beings taking care of each other. ‘‘This is why we do what we do,’’ said Major Rice softly. ‘‘These are the moments we live for,’’ she added with a smile. Nursing Services are integral to the support of global and home base operations. Day after day, we take the best care of our Nation’s heroes at home and abroad. AE continues to be one of the greatest successes in the war on terror, and is the vital link to saving lives. Another example of our AE teams’ heroic efforts occurred when a skilled team of medical personnel worked tirelessly to keep a badly burned 23-year old civilian alive. Having already died and been brought back to life by a shot of adrenalin and cardiopulmonary resuscitation, he was carried by litter onto a C–17 medical evacuation flight from Balad, Iraq to Germany. Lieutenant Colonel Belinda Warren tucked a blanket around the patient and inserted numerous tubes to provide vital fluids to his body. ‘‘You have to make sure the burn victims don’t get cold, replace all the fluids leaking from their burns, and make sure they don’t go into hypothermia or get their blood clotting factors out of whack,’’ she said. As an Air Force Reserve Critical Care Air Transport Team (CCATT) nurse, her goal was to make the patient as comfortable as possible. On a return flight to Germany later that month, she learned that he had about a 20 percent chance of survival, a higher rate than usual, and is doing better than expected, given the severity of his injuries. These critical missions sustain world-class care across the continuum, ensuring our warriors are able to return to the fight with continued healthcare and family support. Since overseas contingency operations began in 2001, over 70,000 patients have been aeromedically evacuated. Year 2009 proved to be a robust one for patient movement. We moved 21,500 patients globally including over 9,000 from the war fronts in Iraq and Afghanistan. Men and women of the 32 Total Force Aeromedical Evacuation (AE) Squadrons were augmented by CCATTs delivering hands-on care in the air. These units are currently staffed at approximately 90 percent, but as the troops in the Area of Responsibility (AOR) increase, additional crews will be needed and are being built to support them. One of our challenges in developing new AE crews is the training pipeline. It currently takes approximately 6 to 9 months to train each new crewmember. The initial phase of this training takes place at our School of Aerospace Medicine and is standardized for the Total Force. Once the didactic portion of AE is completed, flight nurses and technicians return to their units. The time required for nurses and technicians to be qualified on an aircraft can take an additional 2 to 6 months. The Total Force is pursuing a single standardized Flight Training Unit (FTU) similar to that being used by our pilots. This FTU will standardize the upgrade training process across the Total Force by creating a single level of qualification and will, most importantly, shorten the pipeline to approximately four weeks, creating parity among all AE crews. Captain Jac Solghan and his Aeromedical Evacuation Liaison Team’s (AELT) actions provide a great example of what individuals and teams bring to the fight when put to the test. Within 12 hours of landing at Bastion Joint Operating Base, an improvised explosive device (IED) explosion/multi-collision incident injured 5 Afghan National Army personnel and 12 local nationals. After their initial medical assessments and treatments, Capt. Solghan’s AELT responded by providing Afghan patient movement requests for rotary wing airlift. Within 40 minutes, the patients were ready for transport to Kandahar Air Base. Additionally, Capt. Solghan and his team successfully coordinated with the United Kingdom (UK) Aeromedical Evacuation Control Center (AECC) for the transport of a UK solider that suffered a blast injury that left him with only one functioning lung. Capitalizing on the capabilities of the USAF Lung Team stationed at Ramstein Air Base, Germany, and the technology of a Nova artificial lung, this UK service member was transported in the U.S. Aeromedical Evacuation System to Ger- many for critical treatment, and then finally to the Birmingham Military Hospital, UK, where he is now doing well. This success story demonstrated a multinational effort of over 1,000 aircrew, ground, and medical personnel. Capt. Solghan and his team significantly improved the Afghan patient movement system, integrating United States airlift capability with International Security As- sistance Force and Afghan hospital networks. They executed the first-ever United 126

States airlift transport of an Afghan patient to an Afghan hospital and enabled eight new casualty transport routes, increasing inpatient turnover by 70 percent and influencing new joint theater policy. They also initiated joint operations with the Afghan National Army Air Corps, enabling more than 43 patient evacuations with indigenous air assets thus fostering national military airlift capability. Major Louis Gallo, another Air Force nurse, elevated the level of care delivered to our wounded warriors, by leading the first Contingency Aeromedical Staging Fa- cility at Bagram Air Base, Afghanistan. His team set up tents to stage patients as they waited for flights to Germany. He coordinated the procurement of essential communication equipment and support services needed to sustain operations. Know- ing that injured patients needed more than medical care, he contacted the United Service Organization, whose volunteers set up a morale tent within days with supportive and recreational services to aid those awaiting transportation.

HUMANITARIAN As a result of the devastating earthquake in Haiti on January 12, 2010, the Spe- cial Operations Surgical Teams and Special Operations Critical Care Evacuation Teams, assigned to the 1st Special Operations Wing, Hurlburt Field, Florida, deployed with the initial response aircraft and were the first military medical teams on the ground. The intense training and combat experience gained in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) prepared the teams for extremely difficult conditions. They worked around the clock to provide emergency life-saving care to countless American citizens and Haitian Nationals. The teams established treatment areas at the Port-au-Prince Airport and the American Embassy. The Critical Care Nurses provided casualty evacuation of patients both in and out of country as well as pre- and post-operative intensive care unit management. The Nurse Anesthetists assisted in lifesaving surgeries including several amputations, and augmented the ICU. Our Air Force Nurse Corps mission is ‘‘we lead, we partner, we care.’’ These words have never been more relevant as when the nurses and medical technicians of Joint Base McGuire-Dix-Lakehurst repatriated our fellow Americans who survived the horrific earthquake in Haiti. ‘‘Over a 4 day period, around the clock, plane after plane, those three words, ‘lead, partner, and care,’ defined every aspect of the mission we found ourselves involved in,’’ stated Major Robert Groves, Deputy Chief Nurse and Education and Training Flight Commander. He summarized his team’s experiences using the Air Force Nurse Corps mission as a backdrop: —We lead.—Every shift had an assigned Nurse Corps officer and Senior Non- Commissioned Officer, an Aerospace Medicine Services Technician, to organize healthcare, mentor colleagues who had never participated in such an operation, and, of course, to provide care to earthquake survivors. Among the major tasks were organizing the treatment areas in the evacuation operations center, inventorying and obtaining supplies, meeting planes, triaging patients, and assisting with patient transport to higher echelons of care. —We partner.—When operational tasks did not involve direct care, one could find nurses and technicians supporting the endeavors of our other Air Force colleagues. We allowed survivors to share their experiences, played soccer with children in the fitness center gym, assisted them to find appropriate clothing at the donation center, helped them pack new suitcases for their trip to families, and provided the use of personal cell phones to call loved ones to let them know they were okay. For some, these were the first words heard from loved ones in the four days following the earthquake. —We care.—Direct patient care came easily and naturally to our nurses and aeromedical technicians. But, it was more than that. From the beginning of operations it was decided that no survivor would be alone while on the ground in our area. While few evacuees required transfer to higher echelons of care, when they did, there was a member of our team assigned to accompany them throughout the process. Many evacuees had not navigated the American healthcare system. To prevent them from being overwhelmed and lost in an unfamiliar system, one of our team remained with them until they boarded flights to their families. Sometimes it involved overnight stays at local hospitals so they had a familiar, encouraging face during their treatment. In the end, we processed 579 evacuees, with 70 needing more extensive medical care and six requiring transport to community medical partners. But, the knowledge, skills and cooperation with each other and our Joint Base mission partners will be a long-lasting experience and will carry fond memories of our military service long into the future. These four days are what our readiness training had adequately prepared us to do. This is what our service is all about. 127

RECRUITING AND RETENTION A robust recruiting program is essential to keep the Nurse Corps healthy and ready to meet the complex challenges in healthcare and national security. While we have executed incentive programs to address the nursing shortage, shortfalls continue to be an enormous challenge. Today’s nursing shortage is expected to deepen as nursing faculty ages. The capacity for nursing schools to educate sufficient numbers of registered nurses (RN) to meet the future demand is stressed, largely due to the limited number of nursing faculty. On July 2, 2009, the U.S. Bureau of Labor Statistics reported the healthcare sector of the economy is continuing to grow, despite the recession, with more nursing jobs expected to be created in the next decade than in any other single profession. RNs will be in high demand to fill the majority of these positions, as they are the largest component of the healthcare workforce. The BLS projects that nearly 600,000 new RN jobs will be created by 2018. Quality of life and career opportunities, coupled with bonuses, special pays, and other incentives, are critical recruiting tools for Air Force Nursing. Recruiting fully qualified nurses continues to be one of our largest challenges and our historical and present statistics tell us this will be an issue for years to come. In fiscal year 2009, we accessed 284 nurses against our total accession goal of 350 (81 percent), down 12 percent from what I reported the previous year. National competition to access nurses will continue as many professional employment opportunities exist. Our Nurse Enlisted Commissioning Program continues to be a superb resource as we continue to grow our own from our valuable enlisted medics. In fiscal year 2009, of 69 applicants, 40 qualified candidates were selected. In fiscal year 2010, we will meet our steady state goal of 50 quotas per year. The graduates from this program are commissioned as Second Lieutenants and will continue to be valuable assets. As we strive to meet our recruiting goals, NC retention remains challenging. In fiscal year 2009, 267 (almost 10 percent) nurses separated or retired from the Air Force, with 73 percent having 20 years or less time in service and 58 percent being Lieutenants and Captains. With an Incentive Special Pay (ISP) budget increase of $3.3 million compared to last year, our NC ISP is currently in its second year of execution. Seventy-eight percent of our nurses exercised single or multi-year contracts. This year’s focus was to increase retention by recognizing advanced academic preparation, certification and experience. In addition, we expanded the number of nurses eligible for ISP by adding additional Air Force Specialty Codes and clinical settings. While the ISP was not a retention bonus out right, we look forward to seeing a positive impact on retention as a result of this initiative. A number of societal, scientific, and professional developments have stimulated a major paradigm change in graduate nursing education. One major impetus for this change was the American Association of Colleges of Nursing’s (AACN) decision in 2004 to endorse the Position Statement on the Doctorate in Nursing Practice (DNP). This decision moves the current level of preparation necessary for advanced nursing practice from the master’s degree to the doctorate-level by the year 2015. The U.S. Air Force Surgeon General fully supports AACN’s decision, and in response, the Air Force Nurse Corps has researched current practice issues within the Nurse Corps and has developed an implementation proposal for achieving the AACN goals by 2015. Currently, all Air Force Nurse Practitioners are trained through a master’s degree program. The Air Force NC recommends a phased implementation approach to meet the AACN intent. Starting in calendar year 2010, the Air Force Nurse Corps proposes a small pool of Nurse Corps candidates to be selected to attend Doc- tor of Nursing Practice (DNP) programs and by 2015, all students entering the nurse practitioner (NP) career path will graduate with a DNP. In addition, by 2015, all new Air Force NP candidates accessed through the Health Professions Scholar- ship Program (HPSP) will be prepared at the doctorate level. Recruitment of fully qualified NPs has been a challenge and will likely become more difficult with the increased educational requirements. The Nurse Corps must pursue additional incentives to entice DNPs to enter the Air Force.

OPERATIONAL CURRENCY Education and training is the foundation of the Nurse Corps competencies and one of our priorities is to ensure currency platforms meet emerging clinical and operational requirements. The Nurse Transition Program (NTP) continues to be one of our many successes with 10 military and two civilian locations. We graduated 158 NTP nurses in fiscal year 2009. Last year; I reported a civilian partnership with the Scottsdale Healthcare System, in Scottsdale, Arizona was on the horizon. I was honored to deliver the commencement address for the second class in December, where we graduated 15 students. We have partnered with an outstanding Magnet 128 status organization and our new Air Force nurses are getting unprecedented clinical opportunities. At just 6 months, the Scottsdale program is already proving to be a cornerstone in the success of a strong military partnership between Scottsdale Healthcare and Luke Air Force Base, Arizona, located 35 miles east of Scottsdale. From October to December, nurses trained on inpatient units at two Magnet-recognized facilities where they gained hands-on clinical experience and competence in direct patient care under the supervision of nurse preceptors. Their training was further enriched with rotations in peri-operative services, wound care, infusion services, laboratory, pediatrics and the Maricopa County burn unit. The privilege of training in Magnet-recognized facilities is an experience that will prepare our nurses to meet the demands in our stateside facilities as well as in deployed settings around the globe. I am proud of the exceptional work the course supervisors, Majors Deedra Zabokrtsky and Nancy Johnson, have achieved in such a short period of time. The Scottsdale program will begin a steady state of 20 to 25 nurses per class in 2010, making it the largest nurse transition-training site. The 882nd Training Group at Sheppard Air Force Base, Texas, is instrumental in establishing the largest joint armed services medical education and training center that the world has ever seen. To date, the 882 Training Group spent more than 11,000 hours working side by side with their Army and Navy counterparts to consolidate 15 military enlisted medical technical training courses. These collaborative efforts have allowed the three services to incorporate best practices and build state- of-the-art training platforms that will prepare the next generation of medics for the military’s diverse missions. The 882 Training Group began transitioning key and essential personnel in the fourth quarter of fiscal year 2009 and will continue staging instructor staff and equipment to the Medical Education and Training Campus (METC) at Fort Sam Houston in San Antonio through the last quarter of fiscal year 2011 when all courses are projected to be operational. The first METC Senior En- listed Advisor is Chief Master Sergeant Kevin Lambing, an Air Force Senior Aero- space Medical Technician. Our enlisted medical technicians, led by Chief Master Sergeant Joseph Potts, are vital to the achievements of the TNF. One of many outstanding Airmen is Staff Ser- geant Christopher Brown, a medical technician deployed from the 88th Medical Group for 192 days to Kabul, Afghanistan, where he was assigned to Joint Task Force Phoenix VII. SSgt. Brown received a Meritorious Service Medal in recognition of his superior performance as a medical technician while supporting humanitarian missions, conducting medical evacuations, training Afghanistan medics, participating in military convoys, and setting up an Afghanistan medical clinic. He was the sole medic for a 12-person police mentoring team traveling to various remote areas surrounding Kabul to train Afghan police. Assigned to the Afghan Evaluation Transition Team, he was given 14 Afghan medics to train and prepare to treat patients at a bare base. He participated in the longest convoy in OEF history to move the Afghan Kadack to the bare base in western Afghanistan. SSgt. Brown is a fine example of the many committed Airmen who continue to make our Air Force proud. In an effort to increase advanced life support capability at bases, we have trained several of our Aerospace Medical Service Technicians to the National Registry of Emergency Medical Technician-Paramedic level. The inaugural class launched last fall graduated 19 students. This initiative helps reduce the number of contract services in our emergency response platforms by growing our own paramedics from our enlisted force. This will also provide a marketable career path outside the military when these individuals retire. We are expecting an annual growth rate of 50 per year with the vision of providing relief for a stressed career field. Another force multiplier is our Independent Duty Medical Technicians (IDMT). We continue to see a steady increase in our IDMTs as we balance the end strength of our medical technicians. They play an integral role within our Air Force Medical Service as our physician extenders. They are designed to function in a small footprint providing patient care, as well as fourteen other ancillary support functions. The continued efforts to recruit IDMTs have garnered our highest ‘‘true’’ volunteer candidates equaling 24 in the past 10 years. The remainder of our IDMT candidates are gained through the Noncommissioned Officer Retraining Program designed to right size undermanned career fields across the Air Force. Additionally, continuation of the selective reenlistment bonus has aided the recruitment and retention of these valuable assets. Information technology has further enhanced our IDMTs’ capabilities. We supply each IDMT with a hand-held Hewlett-Packard iPAQ that is fully loaded with reference materials, thereby increasing access to the most up-to- date medical information without adversely affecting space and weight limitations of their medical bags. 129

SKILLS SUSTAINMENT For nearly a decade, the Air Force Medical Service has partnered with high volume civilian trauma centers to prepare doctors, nurses, and technicians to care for combat casualties. Maintaining readiness to care for the complex traumatic injuries seen in war is challenging as most military treatment facilities care for lower acuity patients. To bridge this gap, three Centers for Sustainment of Trauma and Readi- ness Skills (C–STARS) platforms were established at the R Adams Cowley Shock Trauma Center in Baltimore, at University Hospital Cincinnati, and at Saint Louis University Hospital. C–STARS Baltimore has a surgical and emergency care focus. C–STARS Cincinnati is designed specifically for the clinical sustainment of Critical Care Air Transport Teams. C–STARS St. Louis serves a range of medical and surgical specialties. In 2009, 817 doctors, nurses, and technicians completed vital training at one of these three centers. Since inception, these partnerships have enabled 4,336 Total Force medical Airmen to maintain clinical currency. During their 2 to 3 week tours, participants complete 90 to 100 percent of required readiness skills through hands-on patient care, supplemented by didactics, cadaver labs, training with patient simulations, and field exercises. In addition to the immersion experience obtained at C–STARS, a complementary initiative was started in 2009 called STARS–P, the Sustainment of Trauma and Re- suscitation Skills Program. Personnel assigned to designated STARS–P military treatment facilities at Wright-Patterson AFB, Ohio; Luke AFB, Arizona; Nellis AFB, Nevada; Travis AFB, California; and Wilford Hall Medical Center, Texas, rotate through local civilian Level I trauma centers as part of their normal duty time. For example, medical personnel assigned to Luke AFB, routinely rotate to nearby Scottsdale Healthcare. As a new initiative, we continue to define processes that best match the needs of the military treatment facility and the host civilian institution; however, STARS–P holds great promise as another approach to honing war-readiness skills. These partnerships with civilian medical facilities have proven to be invaluable to maintaining a high state of readiness to deliver quality care to our Sol- diers, Sailors, Airmen, Marines, their families and coalition partners. Another valuable skills sustainment program is the Critical Care/Emergency Nursing (CC/EN) Fellowship. The three fellowship sites, Wilford Hall Medical Cen- ter, San Antonio, Texas, St. Louis Hospital, St. Louis, Missouri, and the National Naval Medical Center, Bethesda, Maryland, continue to produce superbly trained nurse clinicians. Many graduates have already employed their new skills at deployed locations in Afghanistan or Iraq, and several stationed at the 59th Medical Wing have returned to one or both AORs for more than one tour. Forty-three percent of the San Antonio Military Medical Center graduates have obtained advanced certification as Critical Care Registered Nurses. As of March 2009, 99 of 313 critical care nurses are Critical Care Registered Nurses. Graduates of these benchmark programs are phenomenal and often light years ahead of their peers. Nurse leaders repeatedly report from the deployed environment that our graduates are the best, ‘‘Put into any situation and they simply shine.’’ They have developed critical thinking skills that often exceed those of more experienced critical care nurses. We received updates from two of our June 2009 graduates, Captain Matthew Howard and Captain Lindsay Erickson, both currently serving at Bagram Air Base, Afghanistan. Their comments clearly highlight their enhanced level of clinical and critical thinking skills. Capt Howard stated, ‘‘I in-serviced the staff on ventriculostomies the very first shift I worked. We set a record last month for the most traumas since the war started here, and if we keep going, we will exceed it this month. More importantly, the survival rate is up 3 percent and at a record high.’’ Capt Erickson stated, ‘‘By the end of my second week, a mass casualty situation arose. The unit was full with 16 patients. We moved three non-vented patients to the ward, and quickly acquired six new trauma/burn patients. I started the day with a three-patient assignment and ended up taking one of the new traumas on top of that. It was challenging but I felt very well prepared and took the assignment on without hesitation. No doubt my Critical Care fellowship training prepared me well. One of the burn patients required bladder pressure monitoring. Many of the nurses here aren’t too familiar with this, so I volunteered to teach.’’ The CC/EN Fellowships have set the standard. Our graduates provide the highest quality care, both stateside and in the deployed environment, positively impacting lives on a daily basis. In the area of responsibility, the impact is palpable with a sustained 95 percent survival rate for OIF, and 96 percent survival rate for OEF. 130

ORGANIZATIONAL STRUCTURE The Air Force Medical Operations Agency (AFMOA) in San Antonio, Texas is a single support agency that stood up in September 2008 under the command of Brig- adier General Mark A. Ediger. Nearly 18 months later, AFMOA has progressed as a robust centralized reach-out, reach-back clinical support hub, collaborating with the major commands to standardize business practices across the Air Force Medical Service in pursuit of ‘‘Excellent Healthcare, Clinical Currency.’’ To that end, the AFMOA Surgeon General Nursing Directorate, comprised of three divisions and led by Colonel Leslie Claravall, has concentrated efforts toward developing currency platforms to sustain clinical skills for deployed operations. For example, the Provi- sion of Nursing Care Division, led by Colonel Doug Howard, participated in an ‘‘Emergency Department Analysis and Process Improvement Project’’ in November 2009 and is partnering with emergency services leadership of nine military treatment facilities to employ efficient evidence-based processes. Ultimately, the goal is to increase throughput leading to enhanced patient safety and satisfaction, while providing more experience and opportunity for medics to sustain clinical currency. Other clinical arenas, to include inpatient care and specialty care clinics, will be targeted in the same manner. Additionally, AFMOA Surgeon General Nursing is contributing to efficient healthcare and clinical currency by building tools to enhance mentoring and information sharing. To illustrate, the Education and Training Division, led by Colonel Lilly Chrisman, was key in facilitating ‘‘Mosby on line’’ as an Air Force Medical Service enterprise-wide reference tool. Modernizing access to the most current edition of a sound clinical reference allows our medics to obtain guidance anytime from any computer, while saving countless dollars by averting the distribution of new hard copies to replace outdated ones across the Air Force Medical Service AFMOA Nursing Service Resourcing Division, led by Colonel Robert Hontz, was the last division to stand up this summer. This division analyzed nurse resources across the major commands making recommendations to support Air Force initiatives such as the Medical Home Model for patient-centered care, a new Special Needs Coordination Cell to improve continuity of care for special needs family members, and the plus up of mental health nurses to support increasing deployment demands on a stressed career field. The Mental Health Nurse (46P3) and the Mental Health Nurse Practitioner (46Y3P) Air Force Specialty Code (AFSC) is currently staffed at 77 percent for 46P3 and 100 percent for the 46Y3P. The high mobility tempo of this specialty makes it difficult to retain these critically manned mental health nurses. Currently, there are 30 psychiatric nurses in deployment unit type codes increasing to 40 in fiscal year 2010 to meet the career field’s rigorous mobility requirements. The entire Air Force Medical Service mental healthcareer field is in the Band ‘‘D’’ Battle Rhythm which requires a 1:2 deployment: dwell time. Seven to eight psychiatric nurses are deployed worldwide in support of OIF and OEF each cycle. The Air Force Medical Service is taking steps to alleviate the stressors on the mental health nursing career field, and plans are under way to build a formal training program at the David Grant Medical Center at Travis AFB, California. This course will train clinical nurses to become mental health nurses. Additionally, we are pursuing an increase in mental health nurse and mental health nurse practitioner authorizations. Our goal is to place 10 additional mental health nurses in our bedded military treatment facilities to augment the staff caring for our wounded warriors and other beneficiaries. The advanced clinical capability of our mental health nurse practitioners has been lauded by patients as well as other provider staff. The Air Force Medical Service has ‘‘grown our own’’ through the Air Force In- stitute of Technology program, with 14 of our 15 nurse practitioners having come from our mental health nurse career field.

RESEARCH Air Force nurse researchers are integral to the joint research conducted in the U.S. Central Command area of responsibility. The Joint Combat Casualty Care Re- search Team (JC2RT) consists of six Army and three Air Force members with the mission of fostering and facilitating medical research, performance improvement, and evidence-based practice initiatives for the United States Central Command Joint Operations Area: Multi-National Corps—Iraq Theater, U.S. Forces Afghani- stan, and Kuwait. In March 2009, the Department of Defense medical research program was initiated in Afghanistan under the direction of Colonel Elizabeth Bridges, an Air Force Reserve Ph.D. prepared nurse. Simultaneously, Lieutenant Colonel Te- resa Ryan, also an Air Force Reserve Ph.D. prepared nurse from Keesler AFB, Mis- 131 sissippi was the senior Deployed Combat Casualty Research Team (DC2RT) researcher at Balad, Iraq. Colonel Bridges laid the groundwork for the arrival of a team of six researchers (physicians, nurses, a nutritionist, and a physiologist) who arrived in September to Bagram. Currently, Major Candy Wilson, a Ph.D. prepared nurse, from the 59th Clinical Research Squadron at Lackland AFB, Texas is at Bagram. In August 2009, the JC2RT Headquarters office moved from Ibn Sina, Iraq to Bagram, Afghanistan. In October 2009, Lieutenant Colonel Kevin Bohan from the Graduate School of Nursing, Uniformed Services University of the Health Sciences along with SGT An- drew Coggins, a Army laboratory services NCO, established an office in Kandahar to expand the research program. The nurse researchers assigned to the DC2RT identified the following major areas for research: mild traumatic brain injury, management of complex orthopedic trauma, pain management across the continuum of care, and integration of information from the Level II medical facilities and the en- route phase of care, both medical evacuation and aeromedical evacuation. The teams provide guidance and review for all research conducted in Afghanistan, Iraq and Kuwait. The Ph.D. prepared nurses provide leadership and guidance on scientific merit, design and methodology of research. Each team member is involved in collecting data for a variety of research protocols focusing on combat casualty care. Over 150 research studies have been conducted or are being planned as a result of the JC2RT’s efforts. More than 20,000 subjects have been enrolled in research studies. Areas of research conducted by the U.S. military in Afghanistan and Iraq have led to advancements in combat casualty medical care and therapies to include tourniquet application, combat gauze, life saving interventions, en-route care, resuscitation, blood product administration, burns, wound care, post traumatic stress disorder (PTSD), traumatic brain injury, and infectious diseases. Colonel Bridges, as the first research nurse in Bagram, Afghanistan, from April to August 2009, received Tri-Service Nursing Research Program (TSNRP) funding for a functional hemo-dynamic study in Afghanistan. Since 2006, 34 nursing research protocols have been approved with U.S. Air Force nurse researchers being principal investigators in five of those studies. The overall nursing research themes include warrior care, healthcare delivery, trauma, behavioral health, and nursing/ healthcare professional issues. Nursing principal investigators have investigated pain management, functional hemo-dynamics, and StO2 monitor for occult hypo-per- fusion, carbon monoxide exposure, women’s health, sleep disturbances in soldiers, oral care in the critically ill, retention, recruitment, PTSD, burnout, compassion fatigue, and moral distress in nursing personnel. To date, three Air Force led nursing research protocols are in the final stages of approval by the institutional review board, which researchers by law must submit their research proposal to receive approval before beginning a research study. As a member of the Joint Combat Casualty Research Team, Major Wilson augmented the Combined Joint Special Operation Forces to provide healthcare for local men, women, children and the Afghanistan National Army. During visits to the vil- lages, Maj. Wilson, a nurse practitioner, along with other healthcare professionals, provided medical care for over 10,000 patients during a 6-day period. The rugged and austere healthcare delivery conditions required medical diagnoses to be made based on patient presentation, without the aid of laboratory or radiology analyses. In addition to the direct benefits of the care provided, valuable and actionable intelligence was gathered on these missions that resulted in improved situational awareness by U.S. forces and directly resulted in saving lives of service members. The TSNRP Executive Director position transitioned to Colonel Marla DeJong in 2009, the second Air Force nurse researcher to hold this position. The TSNRP is the only program with the primary mission of funding military unique and military relevant nursing research. Colonel DeJong is responsible for facilitating tri-service nursing research to optimize the health of military members and their beneficiaries. The goal of military nursing research is to produce knowledge that further enhances clinical practice, the delivery of healthcare, nursing education, and nursing management. Since its inception in 1992, the TSNRP has funded more than 300 military nursing research studies and several evidenced-based practice projects. Ultimately, application of this new knowledge improves the quality and delivery of nursing practice, promotes the best possible outcomes for patients and families, and informs healthcare policy decisionmakers. With the support of TSNRP funding, the pocket guide, Battlefield and Disaster Nursing Pocket Guide, which I shared during last year’s testimony, has been distributed to 15,000 Air Force military nurses and medics to augment readiness preparation. During 2009, military nurse leaders, researchers, and stakeholders of the TSNRP revised the mission and research priorities to ensure the funding clearly reflects the mission and research vision of military nurses. The current TSNRP research prior- 132 ities are (1) force health protection, (2) nursing competencies and practice, and (3) leadership, ethics, and mentoring. The TSNRP sponsors Grant Writing Workshops for novice and experienced researchers to learn how to design studies and write high-quality applications that will be competitive for funding. Annually, the TSNRP conducts a Post-Award Management Workshop to inform grant recipients of Fed- eral, Department of Defense, and TSNRP management policies and guidance on grant execution. Results from TSNRP-funded research impacts nursing clinical practice in deployment resilience, retention, methods to reduce ventilator-associated pneumonia, health disparities, and women’s health during deployments. For example, Major Jennifer Hatzfeld who defended her dissertation in 2009, ‘‘Assessing Health Dispari- ties in the Air Force’’ documented the prevalence of health disparities according to race or ethnicity for chronic diseases such as hypertension, high cholesterol, and diabetes among adult Active Duty Air Force members; however, she found no evidence of disparities in the treatment outcomes of patients with these conditions, indicating patients received appropriate medical care. Numerous mission-relevant studies are in progress. Colonel Bridges’ study is designed to evaluate new methods of monitoring patients after hemorrhage on the battlefield. Colonel Penny Pierce, a retired Air Force nurse reservist, and her colleagues have systematically collected comprehensive survey data from deploying troops beginning with the Persian Gulf War and continuing through OEF and OIF. The initial studies focused primarily on military women due to the sociopolitical concerns raised by deployment of large numbers of women, reservists, and mothers of dependent children. Later studies included men and women from the Air Force and Army, enabling researchers to compare findings by gender, military service, and deployed locations. Data collection pertained to physical, mental, and gender-specific health issues. Junior enlisted women and families experiencing economic hardships were particularly vulnerable to work-family conflict. Further, individuals with work- family conflict were at high risk to develop post-traumatic stress disorder. Stressors such as family conflict and organizational issues influenced the physical and mental health of military members and impacted retention. Importantly, these stressors are potentially modifiable. Work is underway to identify interventions that will benefit individuals, families, and the uniformed services. TSNRP-funded researchers continue to disseminate the results of their studies through peer-reviewed publications and numerous presentations at nursing and medical conferences. The TSNRP co-sponsored the Karen A. Rieder Nursing Re- search Poster Session at the 115th annual meeting of the Association of Military Surgeons of the United States. Air Force nurses presented 29 of the 90 posters which summarized the results of recent studies, evidence-based practice projects, and process improvement activities. Colonel Bridges, for example, recommended interventions to prevent complications during en-route care of casualties transported by Critical Care Air Transport Team during OEF and OIF. In addition to her duties as TSNRP program director, Colonel DeJong is assigned to the DOD Blast Injury Research Program Coordinating Office. She organized and hosted an international, state-of-the-science meeting on blast-related mild traumatic brain injury. The meeting resulted in a thorough assessment of knowledge about TBI and identified the gaps necessary to shape future research. Colonel DeJong also co-chaired the Joint Program Committee for Battle Injury Prevention Research and helped execute the $247 million Battle Casualty and Psychological Health Research Program. Colonel Karen Weis, another one of our Ph.D.-prepared nurses, co-authored Psy- chosocial Adaptation to Pregnancy: Seven Dimensions of Maternal Role Develop- ment. Colonel Weis also authored a nurse-physician communication assessment tool used in several military treatment facilities, as well as the Methodist health system in Houston, Texas. The instrument assesses perceived barriers to physician-nurse communication enabling focused attention for improved staffing effectiveness. Colonel John Murray just completed a chapter entitled, ‘‘The U.S. military health system: Meeting healthcare needs in wartime and peacetime’’, to be included in Pol- icy & Politics in Nursing and Health Care. As the Director of Education, Training & Research, Joint Task Force, National Capital Region—Medical, he developed Joint-level DOD Assurance and Issuing authority for research within the National Capital Region. Colonel Murray is a member of the Department of Veterans Affairs (VA) National Research Advisory Council and the VA workgroup for Research on Educational Interventions for Health Professionals. Lieutenant Colonels Patricia Bradshaw and Karen O’Connell, and Majors Susan Dukes, Brenda Morgan, and Antoinette Shin are near completion of their Ph.D. program. These nurses will be deliberately placed as the Nurse Corps builds research specific locations or ‘‘cells’’. 133

We recently developed a nursing research fellowship and the first candidate will begin this spring. This 1-year pre-doctoral research fellowship will focus on clinical and operational sustainment platforms. The intent of this program is for the fellow to develop a foundation in nursing research and ultimately pursue a Ph.D. The desire for evidence-based nursing care is at the forefront of the nursing staff at the 59th Medical Wing, Wilford Hall Medical Center, San Antonio, Texas. Newly hired nurses are oriented to the benefits of nursing research and evidence-based practice during nursing orientation. The deliberate promotion of nursing research has resulted in three nurses developing protocols for funding from TSNRP. Nursing staff from the 88th Medical Group, Wright-Patterson AFB, Ohio, have submitted three research grants this year and are participating in two nursing studies. Major Bonnie Stiffler, the primary investigator for the study, ‘‘Barriers to Screening Mammography for Medical Treatment Facility Enrolled Beneficiaries,’’ is conducting telephone interviews to identify barriers to obtaining provider recommended mammography. The goal is to identify barriers to care and then develop methods to minimize or eliminate the barriers. Colonel Robie Hughes is the primary investigator for a funded multi-site study titled, ‘‘Air Force Nurse Transition Pro- gram Student Quantitative Medical Simulation Performance’’. This study will be the first formal study conducted at the nine Nurse Transition Program sites during a simulated medical scenario evaluating nurse performance from this established 11- week training program.

STRATEGIES FOR THE FUTURE I am proud to report that we have created a Master’s Degree in Flight Nursing with an Adult Clinical Nurse Specialist focus and concentration in Disaster Pre- paredness. This program, the first of its kind in the country, was designed and ready for students in just 3 months. We partnered with Wright State University- Miami Valley College of Nursing, Dayton, Ohio and the Health and National Center for Medical Readiness Tactical Laboratory at Calamityville. Graduates from this program will gain expertise in Flight Nursing as well as emergency and disaster preparedness from military and civilian perspectives. Our first candidate will begin in the spring. The unique and diverse curriculum will meet Homeland Security Presidential Directive #21 and include advanced clinical courses in acute and chronic health issues for the adult population with an emphasis in flight and disaster nursing. The Flight Nursing component will address symptom management and stabilization during air transport. In addition to the classroom training, students will be connected with a preceptor in an active flight nursing setting with both fixed and rotary aircraft at the 375th, Scott AFB, Illinois and Care Flight at Miami Valley Hospital, Dayton, Ohio. Students will be exposed to tragic scenarios to illustrate the impact disasters place on the health and safety of individuals and families. A former 54-acre cement plant in Ohio is being developed into an all-hazards disaster and training facility. This site will be incorporated into joint civilian and military training programs to provide a realistic venue to simulate natural and man-made disasters. Upon completion of this rigorous program, graduates will be eligible to take the Adult Health CNS and American Nurse Credentialing Center certification exams. The Graduate School of Nursing at the Uniformed Services University Health Sciences (USUHS) continues to provide cutting-edge academic programs to prepare nurses with military unique clinical and research skills in support of delivery of patient care during peace, war, disaster, and other contingencies. As they move toward their vision of being a nationally recognized academic leader, while on the forefront of a nurse and nurse educator shortage, the Graduate School of Nursing was asked to collaborate with the Federal Nursing Service Chiefs to increase the cadre of baccalaureate-prepared military nurses, through creative partnerships with existing schools of nursing. One of Uniformed Services University Health Sciences’ top initiatives is to work with civilian nursing institutions to address the military nursing shortage and assist the Department of Defense to identify strategies to encourage and incentivize potential applicants to enroll in baccalaureate nursing programs. USUHS plans to develop and deploy a comprehensive survey to assess the willingness of potential student populations to consider accepting an undergraduate nursing education in return for a commission as a Nurse Corps officer in the Armed Forces with a subsequent service obligation. The targeted populations will include students in nursing school programs, qualified applicants who are not accepted for admission to nursing school due to space limitations, associate-degreed registered nurses, second career nurses, and enlisted service members with a desire to be commissioned as a nurse corps officer. Data from these surveys will be analyzed to identify and quantify perceptions of potential nurse applicants towards military service. 134

As I reported last year, we developed Master Clinician roles to afford our most clinically experienced senior nurses with advanced academic preparation to remain at the bedside without sacrificing promotion opportunities. We have 20 Colonel positions identified across our military treatment facilities and are diligently working to fill these authorizations in fiscal year 2010.

WAY AHEAD Nursing, the essential healthcare profession, is highly valued for providing skilled, evidence-based quality care to Airmen and their families. We continue to arm our nursing service personnel with the necessary skill sets through education, training, and research to meet the challenges of operating in the ever changing global environments. Nurse recruitment and retention continues to be our focus as we develop academic partnerships, sustain our accession programs, reward clinical practice through incentive specialty pay, and enhance nursing capabilities through advanced academic preparation such as the Masters Degree in Flight Nursing and our DNP implementation plan. We look forward to the future. By being actively engaged in nursing research, we are generating the knowledge necessary to guide Air Force and Joint nursing operations. Through the synergy of our AD, ANG, AFRC, civilian, and contract forces, coupled with the collaborative relationships of our sister Services and civilian partners, we are prepared to meet emerging challenges with strength and confidence. Air Force Nursing stands ready today to embrace the challenges of tomorrow as we lead, partner, and care, every time, everywhere. Mister Chairman and distinguished members of the Committee, it is my honor to be here with you today representing a dedicated, strong Total Nursing Force of nearly 18,000 men and women. We sincerely thank you for your tremendous support for Air Force Nursing.

CARING FOR WOUNDED, ILL AND INJURED General HOROHO. Sir, I absolutely believe Army nurses are prepared for those types of injuries. But, it has proven a challenge. You know, years ago, if you asked whether or not Army nursing provided rehabilitative nursing, we didn’t. Post-9/11, absolutely. That’s one of our core competencies. And we’ve worked hand in hand—when we talk about Army nursing, we talk about our Active component, our Reserve component, our National Guard, our medics, and our civilians. All three of those are critical to ensuring that we’re being able to meet the needs of our patients on the battlefield in—both in our stateside facilities. So, when you talk about whether you have the capabilities, every single one of our medics are highly trained, and that’s where we’ve got that life-sustaining care that’s given at the point of injury, and then they’re immediately evacuated back either for our forward surgical teams or back to our combat support hospitals. And then, in 36 hours, those critically injured patients will be seen at Landstuhl Regional Medical Command, and then further evacuated to our major—our nine other major medical centers. And so, we’ve spent the very first year, in 2008, of really looking at every single competency needed to be able to support an expeditionary force, and then we’ve spent this past year changing the way that we leader-develop, changing our competencies, and actually changing how we assign our nurses. So, instead of assigning based on authorizations, we actually assign based on capabilities, so we know where the needs are, what type of capabilities are needed, and then we make those assignments across the Army Nurse Corps. Chairman INOUYE. Admiral. Admiral FLAHERTY. Yes, sir. 135 The Navy Nurse Corps has added a number of programs to keep our staff well trained. As the war began, we saw new injuries and new types of injuries that perhaps we had not cared for before. We also have a workforce that had been deployed and had been at war, and come back with significant skills. So they are part of the training pipeline. They are training each other about what they saw, what they’ve been able to care for, and what now is needed. We’ve partnered with our civilian organizations to get our nurses to some intensive intensive care unit (ICU) care and also some emergency medicine care, because we know they—the corpsmen on the battlefield—are the ones who are providing that wonderful support for that young marine or that young sailor or that young soldier. So, do we have all the answers? No, sir. Are we well prepared and well positioned to go forward with the future of what we see in the injuries? Yes, sir. We have training dollars, we have people in the pipeline for master’s programs, and we are doing all that we can to make sure that that’s shaped appropriately. Chairman INOUYE. General. General SINISCALCHI. Senator Inouye, thank you for your question. Sir, our focus has been on lifelong training, starting from novice through expert. Our nurse transition programs provide us an opportunity to take nurses, right from their bachelor of science degree program, into a transition program that focuses on building clinical competency. And as they progress throughout the professional continuum, we have very robust programs for skill sustainment, for just-in-time training. We’ve partnered with our sister services on developing critical care, trauma, and emergency room fellowships. It’s a 12-year—or, a 12-month fellowship that prepares our critical- care nurses to go into intensive-care settings in the deployed—in deployed operations, and have the advanced skills that they need to take care of our wounded who have traumatic injuries. We’re focusing on mental health specialties. We are in the process of developing a Mental Health Training Program, at Travis Air Force Base in California, which will help us to grow our own. As we recognize the increased need for behavioral health, we can take our clinical nurses and put them through this educational program, at Travis, which will help to grow mental-health nurses. USUHS has developed a Mental Health Nurse Practitioner Program, and they have a unique focus in preparing mental-health nurse practitioners with the skill set they need to meet the challenges with our wounded warriors and their families. Our critical care educational programs, our Nurse Anesthetist Program, our nurse practitioner programs, are very, very robust, and our focus has been on developing partnerships with civilian universities and with USUHS so that, throughout the continuum, we can allow our nurses—afford our nurses the opportunity for advanced clinical preparation and training. I had testified last year that we had started a new role for master clinicians, and this role allows us to grow clinical experts with advanced experience and advanced academic preparation, and allow them to continue to compete for promotion and function at the bedside as true clinical leaders and clinical experts. 136 We realize the increased challenges our flight nurses face with critical-care—movement of critical-care patients. And so, we’ve recently partnered with Wright State University, in Dayton, Ohio, to establish the first of its kind master’s program in flight nursing, with a focus on adult health clinical specialists and homeland defense and disaster preparedness. And we are proud to say that our first student begins this fall. Chairman INOUYE. Thank you very much. All of you heard Senator Murray set forth a few numbers. The suicide rate among service personnel is the highest in 28 years— about 35 percent higher than the general population of the United States. And, surprisingly, over one-third have never been deployed. It was assumed that they were afraid of combat, but over one-third, never been deployed. As I pointed out, nurses spend more time with their patients than doctors because of the nature of their work, but do you believe that our program to attack this problem is adequate? Suicides. SUICIDE PREVENTION General HOROHO. Yes, Mr. Chairman. One of the things that, when we’ve looked at the psychological health in suicide prevention is, we really looked at it through the lenses of each member of the team, because each healthcare provider and ancillary support provides a critical skill set when they’re interacting with our patients; and not just our patients, but also with their family members. We’ve taken the focus of looking at a holistic, kind of, comprehensive view. The Army has been very much engaged, over this past year, of looking at a behavioral health system of care that looks at taking that capability and, How do we surge that across Army medicine, push that into theater by using the electronic virtual behavioral health, so that we establish that relationship while your warriors are deployed? We also have very robust behavioral health and psychological support for the family members. One of the examples that we’re doing right now is with the family members of 5–2 that are deployed. In preparation for them redeploying back, we have already partnered with TriWest, as well as with the local civilian communities and our military health providers, to start providing that support with the reintegration process now, in dealing with issues now, before waiting for those families to reintegrate together. So, it’s really looking at a comprehensive piece of all of our clinical assets, to be able to impact patient outcomes. We have a long way to go, but I believe with the partnering that we’ve established with our civilian community leaders in healthcare, as well as with our sister services, so that we ensure that we are looking at this from a comprehensive perspective. Chairman INOUYE. Admiral. Admiral FLAHERTY. Thank you. As we look at suicides, we look at both the Navy and Marine Corps numbers, and Navy medicine and Navy nursing are playing a key supporting role to our line colleagues. The line runs our program, and we are there in a supporting role. And as our Surgeon General talked about, often it’s 137 relationship—fractured-relationship issues that happen either at home or with a girlfriend, a boyfriend, et cetera—or partners. So, we need to pay attention to that, and we believe the core component of our programs really rests on resiliency. And how do we build internal resiliency for young men and women who, quite honestly, are quite strong, the military families are very resilient, but it’s the stresses of the deployments that often can cause that fracture—so, how do we have our eyes on that? How do we care for each other? And it is, as the SG talked about, it is that shipmate. And I see you today, and I know that you’re not the same as you were yesterday; you’re not as funny as you were yesterday, perhaps. What’s going on? That should be the first red flag to ask the question, ‘‘How are you doing?’’ When people are uncomfortable about asking specific intrusive questions, you can ask, ‘‘How are you sleeping?’’ Because someone’s sleep patterns and their sleep behavior often is a predictor of stress. So, getting our arms around the stress and understanding that. I believe we don’t need a specialist to have that conversation. I believe the Navy nurse has every single skill that they need to have those conversations with people to talk about how well they’re doing. What are their relationships? How are they feeling? And that is the backbone of some of the programs that we’ve put in place. So, it’s resiliency, sir. It’s operational stress control. For the Navy, we talk about ‘‘staying in the green.’’ We travel into—we look at a stoplight; green, yellow, orange, and red. Red means that I’m fractured and I need, probably, some intervention and support. I want to stay in the green; I want to be healthy, I want to eat right, I want to feel well, and I want to be able to do all the things that matter or are important. And we, as Navy support colleagues, try to help people stay in the green. If you get to the yellow, we can get you back to the green. If you get to the orange, we can still get you back to the green. We want to keep you there, so that you stay well and healthy. Chairman INOUYE. General. General SINISCALCHI. Sir, prevention of suicide begins with building a strong wingman culture. Resiliency is key to prevention of suicide. And in February, our Air Force senior leadership supported Lieutenant General Green’s plans for providing targeted, tiered, resiliency training for our high-risk groups. And as we look at the tiered resiliency training, the focus is on instilling resiliency and building that wingman culture throughout an entire career. It begins with foundational training and it continues throughout a career, focusing on groups that are identified as high risk. And as we identify groups that are high risk for risk of suicide, then we implement face-to-face training, increased interaction from the Commander, from the front line supervisor, so that we are doing training and instilling resiliency and building that wingman culture in building that team. Our focus for suicide prevention is on our total force. We’re looking across our Active Duty, our Guard, our Reserve, and our civilian force for suicide prevention. 138

Chairman INOUYE. To close this hearing, may I call upon the nurses, if they so feel, to make their statements. General Horoho.

STATEMENT OF MAJOR GENERAL PATRICIA HOROHO, CHIEF, ARMY NURSE CORPS, DEPARTMENT OF THE ARMY General HOROHO. Mr. Chairman, distinguished members of the subcommittee, it is an honor and a great privilege to speak before you today on behalf of the nearly 40,000 Active component, Reserve component, National Guard officers, noncommissioned officers, enlisted, and civilians that are Army nursing. It has been your continued tremendous support that has enabled Army nursing, in support of Army medicine, to provide the highest quality of care to those that are entrusted to our care. Last year, I promised you an update on the Army Nurse Corps campaign plan that we began in October 2008. Leader development has always been one of the Army Nurse Corps’ foundations, but as we move the Corps forward, we realize the need to develop a strategy to provide overarching, longitudinal training programs to ensure that we are building leaders for the future. A major initiative is the Leader Academy, a virtual construct designed to facilitate and enhance adaptive, full-spectrum Army Nurse Corps leaders. We also determined that there were nurses that needed a standardized clinical transition program to ensure success as they move from academics to nursing practice. In October 2008, the Army Medical Command formally fielded the Brigadier General Retired Anna Mae Hay Clinical Transition Program, named in honor of our 13th Corps Chief and the first female officer in the Army across nine medical centers. During fiscal year 2009, 364 new graduate Army nurses completed the program, and so far this year over 270 have completed this program. The program is designed to ensure that we develop and foster critical thinking, communication, multidisciplinary teambuilding, and deployment skills. The first training and educational platform that we realigned to support our transformation was a head nurse course, and we named it the Clinical Nurse OIC and NCOIC Lead- er Development Course, as a result of recognizing the critical relationship that exists between the clinical nurse, the officer in charge, and the noncommissioned officer (NCO) in charge. The course provides our mid-level managers the opportunity to learn the essential skills to execute sound clinical and business practices. We are equally committed to the growth and the development of our NCOs and soldiers. In fiscal year 2011, we’ll fund two senior NCOs to obtain their master’s in healthcare administration, to ensure that we continue to meet the needs of the 21st century. We are also developing an intensive care course for our licensed practical nurses that will give Commanders the flexibility to use LPNs for transport of critical patients, standardized knowledge, and expand practice opportunities. Finally, the Leader Academy facilitates enhanced, care-long development through the level of our regional nurse executives. We adopted the American Organization of Nurse Executive Com- petencies to ensure the RNE has the knowledge, skills, and expertise to help manage their region’s system of health. We’re trans- 139 forming Army nursing through the development of a nursing care delivery system, in order to perfect nursing care at the bedside. The patient and the family centered system of care has, at its cornerstone, standardized nursing practice. The standardized system of care will enable us to increase quality of care, reduce resources, and ensure standardization and stability of providing quality patient care. This is in support, and will allow the surgeon general’s intent to improve healthcare delivery through standardization from the point of injury through evaluation and return to duty. The system of care will not only standardize nursing practice, but will also enable, for the first time, comprehensive measurements and improvement of nurse-sensitive patient outcomes, while leveraging evidence-based care and practices. Our efforts to transform Army nursing mirror the national initiatives to improve nursing practice in support of healthcare reform. In January 2009, we piloted elements of the system of care at Blanchfield Army Community Hospital at Fort Campbell, Ken- tucky. After 6 months of monitoring this program, the outcome measures showed an increase in nurse and patient satisfaction, an increase in critical lab reporting and pain reassessment, a decrease in nurse turnover, and a decrease in patients that left without being seen in our emergency room, as well as decreases in medication errors and risk management events. Select elements of the system of care are initially being implemented at three of our medical centers. For example, Tripler Army Medical Center has been using healing hours as a goal to promote rest and increase healing through consolidation of patient-care activities and then tailoring the provision of care for each of our individual patients. The Army Nurse Corps is aligned with our seven other Corps within the Army in support of Army medicine to foster evidence- based practice. At every patient touch-point, we’re ensuring that evidence-based practice is the foundation that supports the delivery of care. We’re aggressively realigning expert clinical capability to surge as a bridge between research and clinical practice. In February 2009, the Tri-Service Nursing Research Program (TSNRP) invited nurse scientists from all services to meet and to determine new priorities for TSNRP. Not surprisingly, force health protection was recognized as the number one priority. Deployment research is designed to ask critical questions that cannot be answered other than on the battlefield, and Army nurses are leading the way. There have been 34 nursing-led protocols; 27 of those are from Army Nurse Corps researchers and one joint Army-Air Force protocol. The focus has been on warrior care, soldier health, trauma care, and behavioral health. We also rely on the Uniform Services University Graduate School of Nursing as the strongest educational platform to develop clinical talent. There has been great momentum since I’ve had the honor of introducing the Army Nurse Corps campaign plan to you last year. Our collective success has been the result of compassion, commitment, and dedication. I’m inspired by the pride, enthusiasm, and openness to change that I see across the Army Nurse Corps. 140 We continue to experience amazing progress in each one of our strategic imperatives, and we’re ensuring that the Army Nurse Corps remains relevant and a force multiplier for the Army medicine, the Army, Department of Defense, and our Nation. I continue to envision an Army Nurse Corps in 2012 that will leave its mark on military nursing and will be a leader of nursing practice reform at the national level. Our priority remains the patients and their families, and our common purpose is to support and maintain a system of health. In order to achieve this common purpose, we will let nothing hinder those who wear the cloth of our Nation, and those who took the oath to forever save, protect, and heal. The Army Nurse Corps is committed to embracing the past, engaging the present, and collectively, continuing to work to envision our future. On behalf of the entire Army Nurse Corps serving both home and abroad, I would like to thank you for your unwavering support and the entire subcommittee’s unwavering support, and I look forward to continuing to work with you. Thank you, sir. Chairman INOUYE. Thank you very much, General Horoho. Now may I call upon Admiral Flaherty.

STATEMENT OF REAR ADMIRAL KAREN FLAHERTY, DIRECTOR, NAVY NURSE CORPS, DEPARTMENT OF THE NAVY Admiral FLAHERTY. Yes, sir. Thank you Chairman Inouye. And thank you for the opportunity today to highlight the accomplishments and opportunities facing the Navy Nurse Corps in 2010 as we care for the health of our force. Our Navy Nurse Corps, comprised of Active, Reserve, and Fed- eral civilian nurses—many are here today in the room—are 5,500 strong. My priorities, as Director, have been focused in three areas: people, practice, and leadership. Our Active component is manned at 91 percent, with 2,837 nurses currently serving around the world, and we have already achieved our recruiting goal for 2010. The top three direct accession influences that are favorably impacting our recruiting efforts include the nurse accession bonus, Health Professions Loan Repay- ment Program, and the Nurse Candidate Program. Today, the Reserve component is 83 percent manned, with 1,112 nurses. Last year, the Navy Nurse Corps Reserve component met 87 percent of their goal. Over 48 percent of those accessions were nurses coming to the Reserve component from Active Duty. We are continuing to focus closely on all the many pathways to achieve this goal. Leveraging current technology, the Nurse Corps recruitment liaison officer offers a combination of social networking media tools, including Facebook and Twitter and online discussion forums, to reach students at colleges and high schools, encouraging them to consider a career in Navy nursing. We have found that students have many thoughts, they have questions, and starting this discussion early is essential. Retaining Navy nurses is my top priority. Key efforts have positively impacted retention, including the registered nurse incentive specialty pay, a targeted bonus program for undermanned clinical 141 and nursing specialties and our highly deployed nurse practitioners. My goal for this year is to increase retention by 50 percent in the Active Duty component for those with less than 10 years of service, and to retain the appropriate number in each officer rank in the Reserve component. We want our nurses to accept orders to a second and a third duty station, and begin early planning for their long career. I believe it is our responsibility, as Nurse Corps leaders, to fully understand all of the retention issues. In 2009, we commissioned the Center for Naval Analysis to conduct a survey and hold focus groups to help us understand factors that influence career satisfaction and dissatisfaction within our Nurse Corps. Our nurses told us they wanted us to be more understanding of family needs, career moves, and clinical advancement. We also learned that deployments were professionally fulfilling. We will do all that we can to make the required changes to impact this retention. Clinical excellence is one of the main tenets of the Nurse Corps clinical leadership model. In 2009, we developed and implemented standardized orientation in nursing competencies across all of our nursing specialties. Over the past several years, the Nurse Corps identified eight critical wartime specialties and developed our manning, training, and bonus structures to incentivize nurses to practice within those specialties. Each nursing specialty has an assigned specialty leader who is a clinical expert and understands the nursing practice within each community. We work closely together to embrace practice trends and future requirements. Understanding the deployments and type of care needed by our patients was essential when developing our nurses. To accomplish this goal, the specialty leaders work with senior nurse leaders at the military treatment facilities to create, again, the partnerships with our local civilian hospitals. Our military nurses are cross- trained in local emergency departments, as I mentioned, and in intensive care units. This is just one example of what is possible. We know that the wars have created both visible and invisible wounds, and our warriors and our families have experienced stress. To support the behavioral health needs of our warriors and their families, the Nurse Corps has increased its inventory of psychiatric and mental health clinical nurse specialists and nurse practitioners. This growth will also support the projected expansion of our Marine Corps. I believe that every nurse, as I’ve stated, has the ability to understand the unique needs of their patients, and offer support and guidance at every encounter. I am a fervent supporter of graduate nursing education, research, and professional growth of my nurses, and am committed to the sustainment and growth of the Tri-Service Nursing Research Pro- gram. Each year, approximately 73 Nurse Corps officers are selected for duty under instruction or graduate education program. Fields of study include behavioral health, anesthesia, family practice, research, and critical care. The American Association of Colleges of Nursing has made the decision to move the current level of preparation necessary for advanced nursing practice from the master’s degree to the doctoral level by 2015. The Navy Nurse Corps supports a phased approach toward adopting the doctorate nursing practice (DNP), and will uti- 142 lize a combination of short- and long-term steps to incorporate this degree at options part of our education strategy. Using existing funds, three nurses will graduate with a DNP in 2012, and the DNP degree will be incorporated into the Nurse Corps training plan. As we make the transition to a greater number of DNPs, additional education funding will be required. To expand this clinical leadership model that we have so well achieved over the last number of years to our Federal civilian registered nurses, we launched the Navy Graduate Program for Fed- eral Civilian Registered Nurses, the first of its kind in the uniformed services. We expect that this new program will retain our current civilian nurses, incentivize new nurses to consider entry into Federal service, and sustain military treatment facilities with clinical experts, when our military nurses are deployed. We have funded five competitively selected Federal civilian registered nurses to pursue their master’s of science in nursing. We are currently receiving applications to select our next class of candidates for the fall 2010. Navy nurses at our military treatment facilities in the United States and abroad passionately support the professional development of America’s future nursing workforce by serving as preceptors, teachers, mentors for local colleges and universities, as well as entire health systems. Navy nurses deployed to Afghanistan in embedded training teams are teaching culturally and linguistically appropriate public health measures. In response to the news of H1N1 outbreaks throughout the world, those nurses prepared emergency response plans and training for local forward operating bases and regional hospitals in eastern Afghanistan, well in advance of the cases appearing in theater. And they deployed critical counterinsurgency tactics by performing village medical outreaches to the local community members in Afghanistan. I believe that leadership at all organizational levels is responsible for ensuring that personnel under their charge are healthy and productive. My nursing leaders have developed and are implementing an interactive career-planning guide, useful for mentoring seniors and subordinates at every stage of their careers, because we do ask people to change and move into different jobs. A key role of these leaders is to know their people and help them develop the resiliency to be able to handle stressors and life events. Navy medicine’s Operational Stress Control and Care for the Care- giver Programs have a direct impact on the health and well-being of the force, deployment readiness, and our retention. We know that caring for service members and their families and experiencing their trauma and stress can impact our medical staff. We must be prepared to care for ourselves, to be able to care for others. Chairman Inouye, thank you. Thank you, again, for the opportunity—providing me this opportunity to share with you the remarkable accomplishments of our Navy Nurse Corps and our continuing efforts to meet Navy medicine’s mission. On behalf of the outstanding men and women of the Navy Nurse Corps and their families who so faithfully support them, I want to extend my sincere appreciation for your unwavering support. Thank you. 143

Chairman INOUYE. Thank you, Admiral. Admiral FLAHERTY. Yes, sir. Chairman INOUYE. And now, may I call upon General Siniscalchi. STATEMENT OF MAJOR GENERAL KIMBERLY SINISCALCHI, ASSIST- ANT SURGEON GENERAL FOR NURSING SERVICES, AIR FORCE NURSE CORPS, DEPARTMENT OF THE AIR FORCE General SINISCALCHI. Chairman Inouye and distinguished members, it is an honor to represent the Air Force Nurse Corps. Our total nursing force is comprised of Active Duty, Air National Guard, and Air Force Reserve officer and enlisted nursing personnel. It is a pleasure to serve alongside my senior advisors: Brigadier General Catherine Lutz, Air National Guard; Colonel Ann Manley, Air Force Reserve; and Chief Master Sergeant Joseph Potts, our Active Duty enlisted career field manager. Together, we lead a total force team delivering evidence-based, patient-centered care to meet global operations. On behalf of our total nursing force, sir, thank you for your outstanding support. Your unwavering commitment to our Tri-Service Nursing Research Program, and your continued support of our Nurse Corps Incentive Special Pay Program is genuinely appreciated. Nursing is integral to the support of global operations. Day after day, our nurses and technicians provide care to our Nation’s heroes at home and abroad. Operational capability is the foundation and moral fiber of Air Force nursing. As an example, Lieutenant Colonel Zierold, from Salt Lake City, Utah, led a trauma team at Bagram, Afghanistan. In his words, ‘‘Over a period of 6 months, we took care of more than 1,000 traumas and countless medical admissions. The acuity was high and the injuries were horrendous, but we safely returned 550 injured U.S. servicemembers to their families, children, and spouses. We forever changed the lives of 450 devastated Afghan nationals, and we won their hearts. And the kids; we will never forget the kids. At the time of their discharge, they reached out their little hands and smiled, as if to say, ‘Thank you. I’ll be okay.’ ’’ On this side of the globe, no one could have anticipated the total devastation that took place on January 12, when our Haitian neighbors experienced the massive earthquake. Special Operations surgical teams and critical-care evacuation teams deployed with the initial response aircraft, and were the first military medical teams on the ground. Our critical-care nurses worked around the clock, providing casualty evacuation of patients in and out of theater, as well as pre- and postoperative surgical and intensive care. Our anesthetists assisted in lifesaving surgeries and augmented the surgical and critical care teams. The vital link, sir, to saving lives, is our aeromedical evacuation capability. These critical missions sustain world-class care across the continuum. Since operations began in 2001, over 197,000 patients have been air-evac’d. In 2009 alone, we moved 21,500 patients globally. Our superb flight nurses, technicians in critical care air transports teams have rightfully earned the title, ‘‘Angels of the Battlefield.’’ One such Battlefield Angel, Captain Jack Solgen, of 144 Ballston Spa, New York, and his team successfully coordinated with the United Kingdom Aeromedical Evacuation Control Center for the transport of the British soldier with a traumatic pneumo- nectomy that Lieutenant General Green had mentioned. Two weeks ago, I had the opportunity to personally meet the lung team based at Ramstein Air Base, Germany. They passionately shared their experience of the emergency use of cutting-edge lung-support technology in saving the British soldier’s life. This success story demonstrates a multinational effort of over 1,000 aircrew, ground, and medical personnel. The flexibility and responsiveness of today’s aeromedical evacuation system demands educated and experienced flight nurses with enhanced clinical capability and disaster management expertise. I am proud to report that we created a master’s degree in flight nursing with adult clinical nurse specialist focused in concentration in disaster management. This program—first of its kind—was designed and ready for students in less than 6 months. We partnered with Wright State University, in Dayton, Ohio, to strategically develop this program, and, as I mentioned earlier, our first student will begin this fall. We continue our commitment to provide the best care possible to our men and women in harm’s way. It’s imperative to advance operational medicine through research. Doctorally prepared nurses are integral to advancing multidisciplinary research. In March 2009, the Department of Defense Medical Research Program was initiated in Afghanistan, under the direction of Colonel Elizabeth Bridges, Air Force Reserve, Seattle, Washington, while Lieutenant Colonel Teresa Ryan, Air Reserve, Biloxi, Mississippi, was a senior nurse researcher in Iraq. Research conducted in Afghanistan and Iraq has led to important advancements in combat casualty medical care and therapies. Our nurse researchers provide leadership and guidance on scientific merit, design, and methodology. I am pleased to report that we developed a nursing research fellowship. Our first candidate will begin this spring. This 1-year predoctoral fellowship focuses on clinical and operational research. One of our valuable skill sustainment programs is the Critical Care Emergency Nursing Fellowship. Our graduates provide the highest quality of care, both stateside and in the deployed environment, saving lives on a daily basis. To mitigate the increased demands on mental health nurses, we continue to recruit, educate, and train internally. Currently, 93 percent of our mental health nurse practitioners are Air Force In- stitute of Technology graduates. A formal mental health nurse training program is being developed at David Grant Medical Cen- ter, at Travis Air Force Base in California, to help train clinical nurses to become mental health nurses. Increasing our advanced life-support footprint, we have started several—we have started training several of our aerospace medical service technicians at the National Registry of Emergency Medical Technician Paramedic level. The inaugural class started and graduated 19 students, and we are programming for 50 students annually. A robust recruiting program is essential to keep our Nurse Corps healthy and ready to meet future challenges. While we have exe- 145 cuted incentive programs to address the nursing shortage, we still have shortfalls. In 2009, we assessed 284 nurses against our total accession goal of 350, for an overall 81 percent. Our Nurse Enlisted Commissioning Program continues to be a reliable platform to assess nurses. In 2009, fully—40 qualified candidates were selected. In 2010, we will meet our steady-state goal of 50 quotas annually. Assessing fully qualified nurses continues to be challenging. While the recruitment of novice nurses is going well, the limiting factor is their depth of clinical expertise. Our Nurse Transition Program advances the clinical skills of these new nurses through direct patient care under the supervision of seasoned nurse preceptors. The transition program continues to be one of our many successes, with eight military and two civilian locations. We graduated 158 nurses in 2009. Last year, I reported that a civilian partnership with Scottsdale Healthcare System in Arizona was on the horizon. This past De- cember, I had the honor to deliver the commencement address for the second graduating class. Air Force nurses are gaining unprecedented clinical opportunities as a result of our transition programs. As we strive to meet our recruiting goals, we continue to focus on the retention of our experienced nurses. In its second year of execution, the Incentive Special Pay Program is positively impacting retention. Seventy-eight percent of our nurses accepted a single- or multiyear contract. With a $3.3 million increase, this year’s focus is to improve retention by recognizing advanced academic preparation certification and experience. Through the Tri-Service Nursing Research Program, my colleagues and I commissioned the first-of-its-kind joint research study designed to quantify factors impacting recruitment and retention. An associate investigator for each service will ensure service-specific and across-service initiatives are identified and validated for use in shaping future strategies. A number of scientific, societal, and professional developments stimulated a major change in requirements for licensed practitioners. The American Association of Colleges of Nursing endorsed the position statement on the doctorate in nursing practice. This decision moves the level of preparation for advanced practice from the master’s degree to the doctorate level by 2015. With Lieutenant General Green’s full support, we developed a phased implementation plan, starting in 2010. As I reported last year, we developed master clinician roles to afford our most clinically experienced senior nurses with advanced academic preparation, to remain at the bedside, without sacrificing promotion. We are diligently working to retain and field these authorizations. As we reflect, sir, on the achievements of the past, and the challenges of the present, we look forward to the future. By being actively engaged in education, training, and research, we are generating new knowledge and advancing evidence-based care necessary to enhance interoperability in nursing operations across our services. Through the synergy of our Active, Guard, Reserve, civilian, and contract forces, coupled with the collaborative relationships with our sister services and civilian colleagues, we are prepared to meet emerging challenges with strength and confidence. 146 Air Force nursing stands ready today to embrace the challenges of tomorrow, as we lead, partner, and care, every time, everywhere. Mr. Chairman and distinguished members, it is my honor to be here with you today, representing a dedicated, strong, total nursing force of nearly 18,000 men and women. Thank you, sir. Chairman INOUYE. I thank you very much, General. ADDITIONAL COMMITTEE QUESTIONS General Horoho, Admiral Flaherty, and General Siniscalchi, on behalf of the subcommittee, thank you very much for your testimony, and especially for your service to our Nation. And, through you, the subcommittee wishes to thank those under your command for their unselfish service. Thank you very much. [The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

QUESTIONS SUBMITTED TO VICE ADMIRAL ADAM M. ROBINSON, JR.

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

O–7 AND O–8 NURSE CORPS BILLETS Question. RADM Robinson, what mechanisms are in place to ensure the continuation of both an O–7 and O–8 billet for the Navy Nurse Corps? Answer. Currently Navy Medicine has two designated billets for Navy Nurse Corps, one for an O–7 (Rear Admiral Lower Half) and one for an O–8 (Rear Admiral Upper Half). Our practice has been to have both of these billets manned. Currently, Rear Admiral (lower half) Elizabeth Niemeyer holds the O–7 billet and Rear Admi- ral (upper half) Christine Bruzek-Kohler holds the O–8 billet. RADM Bruzek-Kohler has plans to retire in the Fall of 2010. At the time of the 2010 DOD Congressional Testimony, results of the fiscal year 2010 O–8 Selection Board have not yet been released.

CBOC Question. Admiral Robinson, the Army is planning to open 22 Community Based Primary Care Clinics in 14 different market areas to provide better access for the thousands of beneficiaries who live off post. Have you looked into a similar concept for the Navy and do you plan to promote the Army clinics to Navy personnel and their families serving near them? Answer. A number of primary care practice models, including those from the Fed- eral and private healthcare sectors, were evaluated as Navy Medicine developed the Navy Primary Care Model called Medical HomePort. Navy Medicine is launching a phased implementation of Medical HomePort across the enterprise as the practice standard for primary care. The initial phase will include NNMC Bethesda, NMC Portsmouth, NMC San Diego, NH Bremerton, NH Jacksonville, NH Lejeune, NH Pendleton and NH Pensacola. NHC Quantico will also be part of the first phase during fiscal year 2010. Medical HomePort utilizes a dedicated team of medical providers and support staff designed to increase access to care. The increased access aims to provide continuity for beneficiaries with their provider team, and we expect will improve the health of enrolled patients through preventive health practices, integrated mental healthcare and chronic disease management. We plan to closely monitor the Healthcare Effectiveness and Data Information Set (HEDIS) outcomes for the sites selected for implementation. In addition, this program will allow enrolled patients to access to their healthcare team 24/7 through secure messaging, schedule appointments through patient-preferred modes, and tailored education to their learning style. Navy personnel and their family members who reside within the catchment areas for the Army Community Based Primary Care Clinics would be notified of their en- 147 rollment options for those facilities via the Tricare Managed Care Support Con- tractor (if a Navy medical facility is not available within the area).

DCOE CHAIN OF COMMAND FOR INSTALLATION REPAIRS Question. Admiral Robinson, I am very interested in the growing number of medically focused centers of excellence in the military and how the Department intends to ensure the appropriate level of attention and allocation of resources are devoted to the issues we are faced with today and also those we might encounter in the future. The current centers are focused around known critical areas of concern that impact both the Department of Defense and the Department of Veteran’s Affairs: hearing loss, vision, extremity injury, traumatic brain injury and psychological health. Some of these centers will be located on the Walter Reed National Military Medical Center Campus. What will be the chain of command for responding to each Center’s needs like fixing medical equipment or fixing a leaky roof? Will it be the medical center’s responsibility or Naval Installation Command? Answer. Any Center of Excellence located on the Walter Reed National Military Medical Center Campus will fall under the control of the Medical Center Com- manding Officer and his or her chain of command. Center of Excellence facility repairs will be the responsibility of the Medical Center Commanding Officer and will be resourced through the Defense Health Program (DHP).

NAVY MEDICINE INTERACTION WITH SAFE HARBOR Question. Admiral Robinson, a tremendous amount of attention has been devoted to the care of our wounded warriors. The two main Navy programs designed to meet the needs of wounded service members are the Navy’s Safe Harbor and the Marine Corps’ Wounded Warrior Regiment. Navy Medicine works cooperatively with these programs to develop comprehensive recovery plans. How are the Services interacting with private sector care providers to ensure they have the necessary information on those Service programs relevant to their patients? Answer. Navy’s Safe Harbor and the Marine Corps’ Wounded Warrior Regiment were designed to take care of the non-medical needs of our wounded Sailors, Ma- rines and Coast Guardsmen. Their role is to provide information and assist with access to the resources necessary to support the non-medical needs of our wounded warriors as they recover, rehabilitate, and reintegrate. Coordination of care when individuals transition from military treatment facilities to civilian care is accomplished through the Medical Care Case Managers (MCCMs) and the clinicians caring for the patients. Exchange of medical information occurs through provider to provider communication. Assistance in transition of medical care to the private sector is provided by the MCCM who remains engaged with the patient until they successfully establish a new care provider. Understanding the unique needs of the Re- serve Component with regards to transition of care, especially transition of mental healthcare, Navy Medicine established the Psychological Health Outreach Program. This program is specifically designed to provide an additional layer of support to Re- servists making their transition to private sector or VA care.

FUNDING A WORLD CLASS FACILITY Question. Admiral Robinson, there is a tremendous amount of focus on the establishment of the new Walter Reed National Military Medical Center at Bethesda. One of the latest developments is the effort to make it a ‘‘World Class’’ Facility and to produce a master plan for the campus to accommodate those changes. While Con- gress anxiously awaits the delivery of the master plan later this month, I am very concerned over the expected price tag for these additional projects that haven’t been budgeted. As I understand it, this could cost upwards of $800 million from operation and maintenance and millions more in military construction. As these projects are being evaluated by the Department, are they also determining how these projects will be funded and by which Service? Answer. To carry out the 2005 BRAC law, JTF CAPMED was established to oversee the realignment of Walter Reed Army Medical Center to the new Walter Reed National Military Medical Center in Bethesda and Fort Belvoir Community Hos- pital. JTF CAPMED reports to the Secretary of Defense through the Deputy Sec- retary of Defense. Due to the alignment of JTF CAPMED as an independent DOD entity, Navy Medicine does not direct JTF CAPMED on construction or other priorities, nor are we planning for future operation and maintenance requirements, since that by definition belongs to JTF CAPMED. These emerging priorities and requirements are driven by many things, all of which are outside Navy Medicine’s budget process. As part of our mission to ensure that our Wounded Warriors receive the care they need and deserve, Navy Medicine is in regular communication with JTF 148

CAPMED and continues to provide support as necessary. Because of this regular communication Navy Medicine is aware of the unique challenges facing JTF CAPMED, to include the projected increase of financial requirements. However, specific details of these challenges or the financial requirements cannot be defined or defended by Navy Medicine.

RECRUITING FOR THE RESERVES Question. Admiral Robinson, each Service faces unique medical personnel recruiting challenges but it appears all are having significant difficulties in the reserve component. Could you explain what this is attributable to and what efforts are underway to improve recruitment and retention for the reserves? Answer. Length and frequency of mobilizations are main reasons given for recruiting challenges. The financial and professional implications of being absent from a medical/dental practice, individual or group, for a period of time, are significant. Loss of patient base, medical staff, and support staff all contribute to these difficulties. The benefits and compensation for service do not adequately compensate for these losses. Initiatives currently underway are specific to Corps and specialty. Medical Corps.—Recruiting is focused on Critical Wartime Specialties (CWS) that are currently manned below 80 percent. In addition to a Loan Repayment Program and stipend, physicians who meet the CWS criteria are offered a bonus of $25,000 per year, for a maximum of 3 years. Prior service physicians who do not meet the CWS criteria may receive a $10,000 lump sum bonus for a 3 year drill obligation. However, this has not attracted enough applicants to alleviate shortfalls. We’re currently considering establishing an accession bonus for Non-CWS Direct Commis- sioned Officers which could potentially attract eligible candidates. Dental Corps.—Reserve Dental Corps has a $10,000 lump sum affiliation bonus for prior service General Dentists for a 3 year drill obligation. Overall manning in this community is at 100 percent; however, oral surgeons are in high demand and are manned at only 43 percent. Dentists who are interested in serving in the Navy as maxillo-facial surgeons can qualify for a Loan Repayment Program, stipend, and a CWS bonus of $25,000 per year, for a maximum of 3 years. However, this has not attracted enough applicants to alleviate shortfalls. We’re currently considering establishing an accession bonus for Non-CWS Direct Commissioned Officers which could potentially attract eligible candidates. Medical Service Corps.—Current recruiting incentives for clinical psychologists, physician assistants, and environmental health officers include the Loan Repayment Program, stipend, and a CWS bonus. Navy veterans (NAVETS) may be eligible for an affiliation bonus of $10,000. Nurse Corps.—Current recruiting incentives for Nurse Corps officers in CWS include stipend, Loan Repayment Programs, or CWS bonuses for the following communities: Psychiatric Care, Perioperative, Certified Registered Nurse Anesthetists and Mental Health Nurse Practitioners. An affiliation bonus of $10,000 is available to Navy veterans for all sub specialty programs. In February 2010, we began offering a $10,000 accession bonus for direct commission officers for medical-surgical, maternal infant, critical care, and neonatal intensive care unit nurses.

QUESTIONS SUBMITTED BY SENATOR PATTY MURRAY

NURSE RECRUITING Question. Nurses significantly contribute to the healthcare of our service members and their families. It is important that we maintain appropriate levels of highly trained nurses capable of performing a wide range of healthcare functions. a. With the maintained high operations tempo of combat in Iraq and Afghanistan, and the increasing requirements for healthcare for the service member and their families, are you able to maintain the required level of nurses? b. Are there enough nurses entering the military to ensure quality of care for the service members and to maintain the legacy of superb leadership in the future? c. What are you doing to prepare nurses for senior leadership roles and responsibilities? Answer. a. Retaining Navy Nurses is one of my top priorities. We remain committed to providing a total force of Navy Nurses, balanced in terms of seniority, experience, and skills, to provide the very best care to Sailors, Marines and their families. Key efforts have positively impacted retention, including the Registered Nurse Incentive Specialty Pay, a targeted bonus program for undermanned clinical nursing specialties and highly deployed Nurse Practitioners. Our nurses are enriched by 149 being able to practice in both deployed and garrison care settings. My goal for this year is to increase retention by 50 percent in the Active Component (AC) for those with less than 10 years of service, and to retain the appropriate numbers in each officer rank in the Reserve Component (RC). b. Nurse Corps AC manning is 91 percent, with 2,837 nurses in inventory. We have already achieved the Nurse Corps AC recruiting goal for fiscal year 2010, marking the fourth consecutive year we have met our accession goal. Nurse Corps RC manning is 83.6 percent, with 1,112 nurses in inventory. As of late March 2010, we have met 25 percent of the RC fiscal year 2010 mission of 165 nurses, and we remain focused on this area. I attribute our recruiting successes to the continued funding support for our accession programs, the local recruiting activities of Navy Recruiters and Navy Nurses, and the continued positive public perception of service to our country. A recruiting initiative targeting direct accessions will offer entry grade credit for advanced education and work experience among the critical wartime specialties of Certified Registered Nurse Anesthetists (CRNAs), psychiatric/mental health, emergency room, and perioperative nursing. These initiatives will be expanded to include medical-surgical nurses and critical care nurses as well. c. In addition to sequential assignments to clinical and administrative leadership roles with increasing scope and responsibility, Navy Nurses are eligible and encouraged to pursue leadership training at all stages of their career. Leadership education starts with a 5-week long Basic Officer Development School (ODS) at New- port, Rhode Island before the officer receives their first military assignment. At the mid-grade career level, nurses are encouraged to complete the Basic Medical De- partment Officer Course (BMDOC), followed by the Advanced Medical Department Officer Course (AMDOC). Subsequent to completing these two courses, Nurse Corps officers are highly competitive for nominative assignments to the Interagency Insti- tute for Federal Health Care Executives, MedXellence, and Capstone Courses. Nurse Corps officers interested in senior leadership and executive medicine positions are encouraged to obtain their Executive Medicine Additional Qualification Designation (AQD) through the Joint Medical Executive Skills Institute (JMESI). Mid and senior-level Nurse Corps officers compete for opportunities to attend the Navy War College through distance learning programs or residence assignments.

MENTAL HEALTH AWARENESS Question. The Army has partnered with the National Institute of Mental Health (NIMH) to conduct a long-term study of risk and protective factors to inform health promotion and suicide prevention efforts in late 2008. What is the Navy doing to promote mental health awareness? Answer. The Navy Operational Stress Control (OSC) program and USMC Combat Operational Stress Control (COSC) programs are working together to provide Sail- ors, Marines and their families increased education and awareness to early recognition of those in distress, to mitigate the stigma associated with seeking psychological care and to promote a culture of psychological wellness/health (vice the old paradigm of focusing on mental illness). These programs are Line-led and owned programs, supported by Navy Medicine, designed to provide leaders with tools they can use to recognize and act on early indicators of stress and to understand and use appropriate support resources, including medical and mental health treatment. The end state is a more resilient force. Navy Medicine has developed the Caregiver Occupational Stress Control (CgOSC) program to specifically address our caregivers who are often more prone to adhering to a ‘‘code of silence’’ pertaining to acknowledging personal stress-related issues. A multimedia (print, digital and social media) marketing campaign is underway to further mitigate stigma and increase awareness to resources. Additional mental health awareness initiatives include Project Focus— Family’s Overcoming Under Stress; Combat and Operational Stress First Aid (COSFA); BUMED/Navy Chaplain Corps annual Professional Development Training Seminar’s on Combat and Operational Stress Control for deploying Sailors/Marines as well as a family-focused seminar; and Navy Returning Warrior Workshop’s. Question. Is the Navy conducting long-term studies similar to that of the Army and NIMH? Answer. Navy Medicine is conducting a number of studies to investigate the longitudinal health experience of deployed military personnel. The Naval Health Re- search Center (NHRC) in San Diego, California, is the lead agency for the Millen- nium Cohort Study, which is the largest prospective health project in military history. It is designed to evaluate the long-term health effects of military service, including deployments. The study, which was launched in 2001, currently includes almost 150,000 participants and has already documented a number of risk factors for PTSD and depression following deployments. Other studies are focused on specific 150

Navy and Marine Corps subgroups. For example, the Marine Resiliency Study is a collaboration between NHRC, the San Diego VA, Headquarters Marine Corps, and the National Center for PTSD, is collecting psychological and physiological data on Marine Corps Infantry personnel before and after combat deployments to identify both subtle and overt indices of combat stress. The Marine Resiliency Study documents the incidence of combat-related psychological disorders as well as risk factors for disorders. NHRC is also collecting longitudinal data on Navy and Marine Corps personnel before and after separation from military service. The goal of this effort is to identify factors associated with successful readjustment of Veterans to civilian life. In another effort, the Behavioral Health Needs Assessment Survey (BHNAS) is an ongoing series of surveys and focus groups conducted with Sailors in combat zones to identify rates and causes of psychological problems.

MENTAL HEALTH ASSETS AND SERVICES FOR FAMILIES Question. Family Readiness and support is crucial for the health of the services. The health, mental health, and welfare of military families, especially the children has been a concern of mine for many years. This also includes education, living conditions, and available healthcare. Are you meeting the increased demand for healthcare and mental health professionals to support these families? If not, where are the shortfalls? What improvements have been made with respect to the children of soldiers and meeting their special requirements? What programs have you implemented to assist the children with coping with frequent deployments, re-integration, and other stresses of military families? Answer. Since the beginning of Overseas Contingency Operations, Navy Medicine has increased mental health assets across the enterprise to meet the increasing needs of service members and their families. To meet the specific needs of families, we have implemented several programs targeted at the types of challenges families face as a result of deployments and injuries to the service member. Examples of these programs include: —FOCUS (Families Over Coming Under Stress) is a family-centered resiliency training program based on evidenced-based interventions that enhance understanding, psychological health and developmental outcomes for highly stressed children and families. FOCUS has been adapted for military families facing multiple deployments, combat operational stress and physical injuries in a family member. FOCUS has demonstrated that a strength-based approach to building child and family resiliency skills is well received by service members and their family members reflected in high satisfaction ratings. Notably, program participation has resulted in statistically significant increases in family and child positive coping and significant reductions in parent and child distress over time, suggesting longer-term benefits for military family wellness. In June 2009, the Office of the Secretary of Defense Child and Family Policy determined FOCUS as a best practice program and requested the support of BUMED to expand to select Army and Air Force sites for services. To date over 97,000 service members, spouses, children and community providers have received services on FOCUS. —Navy Fleet and Family Support Centers (FFSCs) offer a wide-range of services to families to include pre- and post-deployment programs. —Ombudsmen/Navy Regional Family Support Liaison; Navy Expeditionary Com- bat Readiness Center’s (ECRC) Individual Augmentee (IA) Family Readiness Program. —The Reserve Psychological Health Outreach creates a Psychological health ‘‘safety net’’ for Navy and Marine Corps Reservists and their families. It improves the overall Psychological Health and resiliency of Reservists and their families, and identifies long-term strategies to improve Psychological Health support services. In addition, Psychological health Outreach Teams have been in place at Navy Reserve Component Commands since fiscal year 2008. —Returning Warrior Workshops provides 2 day workshops designed to support reintegration of deployed Reservists and their family using a weekend-formatted program that includes assisting families in identifying issues during post-deployment, providing resources for issues resolution, sharing common experiences in a comfortable setting, honoring sacrifices endured, and engaging family members and service members with process improvement. 151

TRANSITION OF WOUNDED WARRIORS TO THE VA Question. In the recently released Department of Defense budget guidance, it states that ‘‘caring for our wounded warriors is our highest priority: through improving health benefits, establishing centers of excellence, and wounded warrior initiatives.’’ What system do you have to ensure the transition of wounded warriors from De- partment of Defense to the Department of Veterans Affairs is completed without any unnecessary problems? Answer. To ensure the transition of Wounded Warriors from Department of De- fense to the Department of Veterans Affairs is completed without any unnecessary problems, Navy Case Management (both medical and non-medical) work collaboratively with Federal agencies including the VA. This collaboration includes multidisciplinary team meetings with Navy and USMC Recovery Care Coordinators, Fed- eral Recovery Coordinators, Non-Medical Care Managers, Medical Care Managers and VA Liaisons, patients and their families in developing Recovery Care Plans. Question. What do you consider a successful transition and do you follow-up with the service members to ensure there are no problems even after they have been released from Active Duty? Answer. A successful transition is one that results in the service member and his/ her family’s needs being met to their satisfaction. Navy Medicine Medical Care Managers provide a warm hand off of the medical case management of an individual to VA Medical Care Managers when an individual transitions from Active Duty to Veteran status. This hand off ensures smooth transition of the medical needs of the Sailor/Marine. Navy Safe Harbor and Wounded Warrior Regiment Recovery Care Coordinators and the Federal Recovery Coordinators assigned to these wounded warriors, provide a lifetime of individually tailored assistance designed to optimize the success of the injured service member’s recovery, rehabilitation and reintegration activities. Their involvement with the individual continues through and beyond the transition period.

MENTAL HEALTH STIGMA Question. General Casey recently stated that the number of Army soldiers who feel there is a stigma for seeking mental healthcare has been reduced from 80 to 50 percent. This is a significant improvement, but there is much more work to be done. Despite the reduced number of soldiers who feel there is a stigma, are more service members coming forward to seek treatment? Answer. Yes, Navy Medicine has experienced a 30 percent increase in outpatient mental health encounters for Sailors and Marines over the past 2 years. Greater data analysis is required in order to correlate the impact of reduced stigma and increases in demand. Question. What actions are the services taking to continue to reduce the stigma and encourage service members to seek treatment? Answer. Prior Navy Medicine ‘‘innovations’’ that have now become the norm include operationally embedded mental health providers, integration of Mental Health Care into primary care, Psychological Health Outreach Coordinators and use of our Deployment Health Centers as destigmatizing portals of care. Navy Medicine has also developed the Caregiver Occupational Stress Control (CgOSC) program to specifically address our caregivers who are often more prone to adhere to a ‘‘code of silence’’ pertaining to acknowledging personal stress-related issues. Another innovative program is the multidisciplinary team assessment of every patient that is medically evacuated from theater to identify potential cognitive and psychological health issues. Access is increased in a non-stigmatizing manner by providing this assessment to all patients without need for consult or self-referral. Follow on care is provided as indicated utilizing all members of the multidisciplinary team. The Navy Operational Stress Control (OSC) program and USMC Combat Operational Stress Control (COSC) programs are working together to provide Sailors, Marines and their families increased education and awareness to facilitate early recognition of those in distress and to help combat the stigma associated with seeking psychological care. A multimedia (print, digital and social media) marketing campaign is also underway to further mitigate stigma and increase awareness to resources. Question. Does your plan include the mental health of families, and if so what is that plan? Answer. Yes, Navy medical care is ‘‘patient and family centered care’’. The psychological health of our families is crucial in maintaining a health fighting force. Navy Operational Stress Control (OSC) is developing specific Family OSC curriculum in collaboration with our life educators from Fleet and Family Support Centers. Project 152

FOCUS (Families Over Coming Under Stress) is a family-centered resiliency training program based on evidenced-based interventions that enhance understanding, psychological health and developmental outcomes for highly stressed children and families. Navy Medicine has partnered with the Navy and Marine Corps Public Health Center and USMC COSC to develop and pilot a Family component to the USMC Operational Stress Control and Readiness (OSCAR) program.

QUESTIONS SUBMITTED BY SENATOR PATRICK J. LEAHY

NAVY MEDICINE USE OF SOFTWARE Question. DOD renewed its contract with a Vermont medical firm, Problem- Knowledge Couplers (PKC), last fall. DOD licenses 95 standard PKC tools and six custom tools used for deployment and readiness medical processes. PKC is presently including the six custom tools into a single ‘‘CHART’’ smart-questionnaire, migrating these tools from a Windows to a web-based interface, and preparing a set of web-based medical history questionnaires for patients to complete online prior to the medical encounter. DOD has not yet issued a Department-wide policy on how the Services are to employ the CHART tool. How does your Service plan to use CHART? Will you issue a policy directing how it is to be used, since employing it will substantially change the workflows of Service medical practitioners? As for the medical history questionnaires, the use of this tool by the Services will put DOD in the very forefront of medical information technology innovation. Can each of you describe how your Service will direct the use of these questionnaires, educate your medical professionals about their existence and value, and track and oversee their full integration into patient contact processes? Answer. PKC couplers in their current configuration are in use at a limited number of locations for routine screenings such as the annual Periodic Health Screening. The current version of the tool does not represent an ideal configuration for efficient use with our current systems. CHART is currently undergoing testing for use with our current systems. Once the testing is complete the tool can be examined for routine use as a screening tool by both clinical and technical experts. Once the technical examination is complete, Navy Medicine will consider how CHART can be best utilized. Once Navy Medicine decides how CHART may be used, web based training as well as live training at our individual treatment facilities can be utilized to train the healthcare team.

DEFENSE CENTERS OF EXCELLENCE Question. Would you each describe the relationship of your Services to the De- fense Centers of Excellence for Psychological Health and Traumatic Brain Injury? How do you share and receive information and support from these Centers? How timely are they in responding to requests from support from your Services? What is the relationship between your Services and the centers of excellence directed by the 2008 and 2009 National Defense Authorization Acts related to hearing loss and auditory system injuries, military eye injuries, and traumatic extremity injuries and amputations? How mature are these organizations, at what level are they staffed, and do you find that those staffing levels are sufficient to support the needs of your Service in each medical area? Answer. Navy Medicine works collaboratively with the Defense Centers of Excel- lence for Psychological Health and Traumatic Brain Injury and its component centers: Defense and Veterans Brain Injury Center (DVBIC); Center for the Study of Traumatic Stress (CSTS); Center for Deployment Psychology (CDP); Deployment Health Clinical Center (DHCC); National Center for Telehealth and Technology (T2); and the National Intrepid Center of Excellence (NICoE). Navy Medicine provides staffing to the DCoE, but also has been working to ensure that Navy Medicine professionals—clinicians, researchers, educators and program managers—are working collaboratively with the DCoE staff to improve their important research, education and outreach efforts. We are encouraged by the work of the DCoE and look forward to working with ASD (HA) and the other services to determine the best organizational structure and way forward. Preliminary work is underway in support of the ASD (HA) plan to designate each of the Services with lead operational support responsibilities for one of these Centers: Navy—Vision Center of Excellence; Army— Center of Excellence for Traumatic Extremities and Amputations; and Air Force— Hearing Center of Excellence. ASD (HA), along with the Services’ Surgeons General, 153 are in the process of evaluating organizational models to best support the DCoE mission.

QUESTIONS SUBMITTED BY SENATOR BARBARA A. MIKULSKI

MENTAL HEALTH PROFESSIONALS Question. DOD has a critical shortage of mental healthcare professionals. During review of the Fort Hood incident where the alleged gunman, Major Hasad, U.S. Army psychologist, is charged with the deaths of 13 victims, reports show discrep- ancies in documentation and counseling as it related to his professional abilities and behavior. Suggestions were made that he was kept on active duty with no negative reprimands because he had diversity as a Muslim to our nation’s service despite his failure to perform. What is DOD doing to recruit more mental health workers and to ensure they are quality healthcare professionals? What are the roadblocks to meeting the shortage of mental health professional? Answer. Navy Medicine has been successful in hiring civilian and contract mental health providers. The difficulty is the long training pipelines required to access and train our military mental health providers. The majority of our military mental providers are either trained in-house, through student pipelines or both. For example a Psychiatrist training pipeline includes 4 years of medical school, 1 year of internship and a 3 year Psychiatry residency. These long training timelines impact our ability to replace and increase our inventory of military Psychiatrists with any expe- diency. Clinical Psychologists and Social Workers were recently approved by Navy for accession bonuses beginning in February 2010. We believe these new bonuses will impact direct accession of fully trained Clinical Psychologists and Social Work- ers. Question. What is being done to reduce the stigma and provide enough care givers so soldier and their families do not suffer in silence? Answer. Navy Medicine has focused much attention on reducing stigma and ensuring that an adequate number of mental health professionals are available to care for our beneficiaries. Mental health providers are routinely embedded with our operational units, both ashore and afloat. Seventeen Deployment Health Centers (DHCs) were established in fiscal year 2006 as non-stigmatizing portals of care in high Fleet and Marine Corps concentration areas. The DHCs augment existing MTF resources with an additional 170 multi-disciplinary contract positions, including psychiatrists, psychologists, and social workers, and provide a robust capability to screen, evaluate, and treat Service members for deployment related health concerns. In a major initiative, efforts are underway to integrate mental health providers into our Pri- mary Care Clinics, further improving access and reducing stigma. Additional mental health providers have been hired in recent years to support a host of other programs, including psychological health outreach and family support and counseling. The Navy Operational Stress Control (OSC) program and USMC Combat Oper- ational Stress Control (COSC) programs are working together to provide Sailors, Marines and their families increased education and awareness to facilitate early recognition of those in distress and to help combat the stigma associated with seeking psychological care. Navy Medicine has developed the Caregiver Occupational Stress Control (CgOSC) program to specifically address stress in our caregivers. Question. How is Navy Medicine integrated into the suicide prevention programs to ensure mental health services are getting to those who need it before it is too late? Answer. Navy Medicine personnel (military and civilian) are required to receive annual awareness training to improve ability to recognize risk factors, warning signs, and protective factors related to suicide and know how to assist someone in need to get care. Medical facilities and all Navy commands must have written crisis response plans with consideration of safely reaching, engaging and transporting an individual in acute risk to care. Navy suicide prevention is part of a comprehensive effort in the Navy to educate Sailors, families, and leaders to recognize and act on early indicators of stress and to understand and use appropriate support resources, including medical and mental health treatment.

WOMEN’S HEALTH: CERVICAL CANCER Question. Cervical Cancer is preventable. In 2009 over 11,000 American women were expected to be diagnosed with cervical cancer and over 4,000 women were expected to die from the disease. More than one-half of women who die from cervical cancer have never been screened or have not been screened in the past 5 years. 154

Human Papillomavirus (HPV) testing is an approved and widely accepted test to search for cells that have the potential of turning cancerous. Research has proven that when performed together with cytology screening, it increases detection of abnormal cell changes by 30 percent. National medical organizations and insurance companies have determined screening of HPV testing and cytology screening at the same time as the standard of care, however Tricare has deemed HPV testing authorized only after a negative cytology exam. What is Navy medicine doing to ensure its female patients are receiving the highest quality of cervical cancer screening available? a. What is the percentage of female patients who receive current standards of screening within the required timeframes? b. Is HPV tests available at all Navy MTFs? c. What is Navy medicine doing to increase prevention efforts of their female patients from developing cervical cancer? Answer. Navy Medicine is dedicated to ensuring that all patients receive the highest quality of care. All female patients who present for care have the opportunity to be screened for cervical cancer, following the guidelines of the USPSTF (United States Preventive Services Task Force). (a) The percentage of female patients who are screened is 85.9 percent (December 2009—the most current data from the Population Health Navigator). To put this figure into context, the civilian HEDIS Benchmark for 75th percentile is 84.6 percent and for 90th percentile is 87.8 percent, so we fit in with national norms. Our true measure for cervical cancer screening is actually a little higher, as our current data systems are not able to exclude women who have had a hysterectomy and no longer need to be screened. All active duty patients are screened according to guidelines; however, for our family members and other non-active duty beneficiaries, we can screen only those who present for care. (b) Yes. HPV testing and vaccinations are available through all Navy MTFs. (c) Navy Medicine is very proactive in providing patient education regarding cervical cancer through both patient/physician discussions and community public health outreach efforts via various media formats. The HPV vaccine is available for all beneficiaries in accordance with recommended guidelines.

QUESTION SUBMITTED BY SENATOR THAD COCHRAN

VA SHARING AGREEMENTS Question. Admiral Robinson, the Department of Defense and the Department of Veterans Affairs are establishing joint ventures in hospitals that are co-located around the country, in hopes to achieve efficiencies with combined personnel and shared resources, thus eliminating duplication. Currently, as you know, the Navy and the VA are working on a joint venture in North Chicago, where the plan is to operate the facility with a single civilian staff under the VA, operating out of one combined facility. The Air Force and the VA are also working toward a joint-venture between Keesler and Biloxi, but have adopted a different model than the North Chicago model. I understand the Air Force has stated that not every joint venture will be applicable to every location, and thus the Air Force is not inclined to follow the North Chicago model. One of these reasons might be due to the different mission focus between the two locales. For example, the North Chicago facility supports mostly non-deployable personnel (Navy recruits) and serves as a schoolhouse for medical trainees. In Keesler, many of the medical Airmen deploy in their respective Air Expeditionary Force rotations (AEF) and for humanitarian missions, as needed. Admiral, what are your thoughts regarding the joint venture in North Chicago? In your opinion, is total consolidation between the Navy and the VA the best answer for meeting the Navy mission at Great Lakes? Finally, do you believe this is the model of the future for other Navy-VA joint ventures? Or will the Navy look at other models of implementation, depending upon the mission at that location? Answer. The total consolidation between the Navy and the VA in North Chicago will allow Navy Medicine to meet our mission in Great Lakes. The fully integrated joint venture in North Chicago is a model that has evolved over 10 years of expanding and developing extensive resource sharing between the two Departments. Prior to plans for consolidation in North Chicago, the Navy was moving forward with programmed replacement ambulatory care center to replace the aging Navy hospital. Simultaneously, discussions were taking place within the VA to close their North Chicago facility and reassign the workload to both Milwaukee and Chicago 155

Veterans facility. A decision was made to explore a joint Federal solution to combine both the Navy-VA healthcare missions, which would provide a more cost effective solution to meet the healthcare needs of a wide array of active duty, veterans, and dependent beneficiary populations. This combined healthcare project is in its 10th year of evolving from planning to operational status with many of the integration challenges having been addressed such as the reconciliation process and the IT solutions for interoperability. The current demonstration project will commence October 1, 2010 and is expected to extend efficiencies gained through local consolidation and use of a single chain of command, as well as single systems for personnel, logistics, and financial management. The Department of Veterans Affairs, North Chicago will be the lead executive department. Following review of the financial and personnel systems, workload and patient satisfaction surveys, this fully integrated facility may become the model for future DOD and VA operations where appropriate. Navy Medicine, the Depart- ment of Defense and the Department of Veterans Affairs are already establishing joint ventures with the goal of eliminating duplication.

QUESTIONS SUBMITTED BY SENATOR ROBERT F. BENNETT

CHIROPRACTORS Question. I’m pleased that TRICARE has worked over the past few years to expand chiropractic care for service members. Indeed, I have heard one of the top complaints of returning soldiers has been the type of neck and back pain that chiropractic care would seemingly address. Given the strains placed upon our soldiers in theater, what consideration (if any) has been given to commissioning chiropractors, such that they can be deployed and provide care for our soldiers abroad? Are there any obstacles currently in place that would prevent you from doing so? Answer. Approximately 25 percent of entrants to the Navy Medical Corps currently have the Doctor of Osteopathy degree. The manipulation skill set is available in this group of physicians who are widely deployed in support of theater operations. More importantly, these physicians along with orthopedic surgeons and sports medicine physicians are more versatile in their use in theater and at home. Additionally, physical therapists, now doctorally prepared, also have the skill set necessary to address neck and back pain as well as the full spectrum of other mus- culoskeletal complaints widely experienced by deploying service members. Physical therapists are deploying with service members, and there is a desire to expand this availability. The Navy Medical Department prefers to use full spectrum physicians and physical therapists rather than limited spectrum providers to meet the needs of its beneficiaries.

CHIROPRACTORS AT MTFS Question. In fiscal year 2009, Congress required that 11 new Military Treatment Facilities be staffed with chiropractors by the end of last fiscal year. I have listed the specific locations of those positions that were announced below. To my knowledge only 4 have opened up—what is the status of each of those 11 new positions? Air Force 1st Special Operations Medical Group, Hurlburt Field, Florida. Army Irwin Army Community Hospital, Fort Riley, Kansas. Lyster Army Health Clinic, Fort Rucker, Alabama. Bayne-Jones Army Community Hospital, Fort Polk, Louisiana. Bassett Army Community Hospital, Fort Wainwright, Alaska. Landstuhl Regional Medical Center, Germany. Grafenwoehr Army Health Clinic, Germany. Navy Naval Health Clinic Quantico, Virginia. Naval Branch Health Clinic Groton, Connecticut. Naval Hospital Lemoore, California. U.S. Naval Hospital, Okinawa, Japan. Answer. Navy Medicine currently has contract chiropractors at NHC Quantico, NBHC Groton, and NH Lemoore. NH Okinawa presently does not have a chiro- practor. Additionally Navy Medicine has contract chiropractors at NH 29 Palms, NH Beaufort, NH Bremerton, NH Camp Lejeune, NH Camp Pendleton, NH Pensacola, 156

NHC Cherry Point, NHC Great Lakes, NHC Hawaii, NMC Portsmouth, NMC San Diego and NNMC Bethesda.

QUESTIONS SUBMITTED TO LIEUTENANT GENERAL ERIC B. SCHOOMAKER

QUESTIONS SUBMITTED BY SENATOR BYRON L. DORGAN Question. My staff has made repeated requests for this report. In response I have received a letter acknowledging my request, and repeated assurances that the review is in process. Does the Department of Defense intend to complete a review of TRICARE standards for residential treatment centers, including the 24 hour nursing requirement? When will the report be complete? Answer. Yes, the review has been completed and TRICARE is working to modify certain requirements related to the certification of residential treatment centers, including those setting standards for overnight medical care in such settings. How- ever, to fulfill the requirements of the report, the Department must change our regulation on standards. The timeline for the report is predicated on how soon the regulation can be changed. As soon as the report is completed, it will be sent to all the appropriate Committees. Question. On March 17, 2009, the Federal Register published a final rule on the inclusion of the TRICARE retail pharmacy program as part of the DOD for the purpose of the procurement of pharmaceuticals by Federal agencies. This program requires pharmaceutical manufacturers to provide, at minimum, a 24 percent discount on prescription drugs. The final rule estimated the resulting savings to the Depart- ment of Defense would be over $12 billion in fiscal years 2010–2015. Is DOD on track to obtain the estimated savings? Are all drug manufacturers complying with the requirements? If not, what steps are being undertaken to ensure that the Federal pricing is obtained? Answer. Yes, the Department is on track to obtain savings on prescription drugs. However, the initial Independent Government Cost Estimate (IGCE) done in 2008, relied on 2007 data from Pharmacy Data Transaction Service. The IGCE also based several significant assumptions on data published by CBO that was from 2002 and 2003, a period which experienced higher inflation and price changes than what was seen in 2006 and going forward. Therefore, the IGCE based on these assumptions and data available at that time and calculated a initial savings rate of 35 percent. This calculation of 35 percent was proved incorrect due to the inaccurate data used. In order to have an accurate calculation of the savings, in February 2010, the Pharmacy Operations Directorate (POD) provided information to OMB Budget Offi- cials concerning differences between the projected savings of the Federal Ceiling Price (FCP) program and our recalculations of projected savings based on actual refund data to date. The corrected calculations, provided by the POD in February 2010 using actual data, yielded a rate of 28 percent. It is anticipated that our FCP refund estimates will continue to be refined as we have more experience with the program, receive additional quarters worth of refunds, and develop more precise methodologies for determining future refunds. As of August 27, 2010, fiscal year 2010 total collections (DHP/Non-DOD/MERHCF) for pharmacy rebates were $664 million. Yes, almost all manufacturers have opted in for all of their drugs for purposes of preserving preferred uniform formulary status and no manufacturer has opted out of the program. If that were to occur, the most likely outcome would be to switch to another drug in the drug class. In the unlikely event that this would not be medically sufficient, DOD could use the preauthorization, transition, and waiver/compromise processes under the Final Rule to ensure that patient needs are met.

QUESTIONS SUBMITTED TO LIEUTENANT GENERAL CHARLES B. GREEN

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

COMMUNITY BASED PRIMARY CARE CLINICS Question. General Green, over the years the Air Force has transformed its medical care more toward clinic based rather than large military treatment facilities. Are there lessons learned from your experience providing care in a clinic setting that the Army would find beneficial as they plan to open 22 Community Based Primary Care Clinics? 157

Answer. A solid business plan is required to ensure long term viability of the clinic. Enrollment based clinics drive different practice than a fee for service clinic that requires many procedures to cover the operating costs. Most medical care is provided in the outpatient arena, which meets the majority of our beneficiaries’ needs. We have learned the importance, particularly in free-standing outpatient clinics, of providing patients a Medical Home with good access to their provider, continuity of care and a relationship with a Family Health Team. Family Health providers require specialty care resources to complete the spectrum of healthcare delivered for patients with disease and injury. Specialty consultation can sometimes result in fractionated care, particularly when it requires referral outside the medical treatment facility. The central tenet of the Air Force Medical Service’s Medical Home is a focus on referral management, disease management, and a team approach to healthcare to ensure coordinated care that anticipates each patient’s needs over time. We are also working to expedite the flow of relevant research information from the medical journals to our providers’ desktops to improve medical management. Another important effort is that the Air Force has hired 32 full-time behavioral health providers to embed in our primary care clinics to facilitate mental health treatment in the primary care setting. Research shows that over 70 percent of physical complaints have a psychological component and the vast majority of psychotropics are prescribed in primary care. Via this program, mental health providers are embedded in Primary Cares to provide consultation and brief intervention to our beneficiaries, who often do not seek or follow through with specialty care. This program streamlines the process for beneficiaries, providing brief mental health intervention when and where needed.

HEARING CENTER OF EXCELLENCE Question. General Green, I am very interested in the growing number of medically focused centers of excellence in the military and how the Department intends to ensure the appropriate level of attention and allocation of resources are devoted to the issues we are faced with today and also those we might encounter in the future. The current centers are focused around known critical areas of concern that impact both the Department of Defense and the Department of Veterans Affairs: hearing loss, vision, extremity injury, traumatic brain injury and psychological health. Since the Air Force will likely be the executive agent for the Hearing Center of Excellence, can you detail the role you believe the Air Force should play in developing the operational and research requirements as well as resourcing the Center to meet those needs? Answer. The establishment of a Hearing Center of Excellence is well underway. The Hearing Center of Excellence is positioned to roll out the necessary programs to connect, coordinate and focus the Department of Defense (DOD) and Veterans Af- fairs (VA) tracking, clinical care and research efforts for each injured military member and our expanding population of auditory disabled veterans. In October 2009, the Air Force was designated as the lead component and is standing up the Hearing Center of Excellence in partnership with the VA, Navy, and Army. The Executive hub will be located in San Antonio at Wilford Hall Med- ical Center within the 59th Medical Wing. The Hearing Center of Excellence office will be comprised of a lean cadre of staff working as an administrative hub leveraging technology to create and sustain a network of regional treatment facilities. This network will provide coordinated research and treatment. The Center staff will include a cadre of otolaryngology, speech and audiology professionals from within DOD, VA, and civilian settings. Wilford Hall Medical Center is an ideal site for the Hearing Center of Excellence hub. With ten Air Force, and five Army otolaryngologists and nine audiologists, Wilford Hall is the most robust clinical otolaryngology and audiology department in the DOD and VA systems. Wilford Hall is integrated with Brooke Army Medical Center in Graduate Medical Education in otolaryngology and audiology. The Wilford Hall/Brooke Army Medical Center partnership provides support for the Audie Murphy and Central Texas VA hospitals, and provides didactic and surgical training support for the University of Texas at San Antonio Medical School. This local support underpinning the Hearing Center of Excellence hub will ensure success as links with regional DOD and VA facilities are developed. The BRAC-directed coalescence to the San Antonio Military Medical Center construct will provide convenient, top-quality platforms that are critical for focused clinical and research activities. The Wilford Hall otolaryngology department has a strong legacy and understanding of deployment medicine supporting special operations, aeromedical evacuation, and humanitarian roles and is keenly aware of the ongoing dichotomy faced 158 by our troops between hearing protection and the essential need for optimal situational awareness and communication. Wilford Hall audiology has a solid deployment and research foundation and a working relationship with the Army medical facilities, the VA system, and the Institute for Surgical Research. They have established collaborative teaching and research ties with the Navy, acclaimed universities, and national and international industry leaders. The San Antonio military medical community supports Fort Hood, the Army’s largest armored post, the Center for the In- trepid, all Air Force entry-level enlisted training and the new Medical Education and Training Campus on Fort Sam Houston. Since the designation of the Air Force as lead component for the Hearing Center of Excellence, the Interim Director has worked with the tri-service/VA working group to draft the concept of operations and to direct and define the functional needs for the hearing loss and auditory injury registry. The lead component structure is supporting cross-talk between the DOD Centers of Excellence and will lead to well coordinated efficiency of operations by sharing many functions.

WILFORD HALL CLOSURE Question. General Green, you are dealing with the closure of Wilford Hall in San Antonio, Texas resulting in a combined medical facility with the Army. Please detail for the subcommittee how each Service is integrating and coordinating the various approaches to military medicine and serving their unique populations? Answer. The Base Realignment and Closure (BRAC) 2005 Law, Business Plan 172, states that we are to ‘‘realign [not close] Lackland Air Force Base, Texas, by relocating the inpatient medical function of the 59th Medical Wing to the Brooke Army Medical Center, Fort Sam Houston, establishing it as the San Antonio Mili- tary Medical Center and converting Wilford Hall Medical Center to an Ambulatory Care Clinic.’’ With your support, we are on track to meet the BRAC deadline to transition all inpatient care to the Brooke Army Medical Center and establish a combined San Antonio Military Medical Center. The 59th Medical Wing’s Ambula- tory Care Clinic is also a critical component of this integrated military health system in San Antonio. To ensure we appropriately realign and integrate clinical operations, the Military Health System is modernizing these key facilities. The result will be the efficient and effective provision of world-class military medicine within the greater San Antonio area. We are capitalizing on prior collaboration and expanding new agreements. To ensure integration manner we are mixing resources at the market level to provide best value military healthcare for San Antonio. Examples are integration of graduate medical education under the San Antonio Uniformed Services Healthcare Education Consortium; fully integrated department leaders; collaborative basic and clinical biomedical research; and a San Antonio Healthcare Advisory Group to facilitate privileging, clinical business operations, healthcare management, and strategic planning. Efforts are ongoing with regard to governance structure, but our vision is a Service lead of the joint hospital and the joint ambulatory surgery facility, each staffed by both Army and Air Force personnel, similar to the Landstuhl Regional Medical Cen- ter model. The Army and the Air Force have worked diligently to integrate operations and improve military medicine delivery, while meeting the needs of each Service’s beneficiary population and sustaining the readiness skills and focus of the military’s medical force.

HEALTH PROFESSIONS SCHOLARSHIP PROGRAM Question. General Green, the Health Professions Scholarship Program is one of the best mechanisms to recruit medical personnel into the Services. This program provides 4 years of tuition, books, and a monthly stipend, yet only 25 percent of all graduates of this program stay in the Service after the initial 4 year commitment. After spending hundreds of thousands of dollars training these medical professionals, how can we do a better job of retaining them in either the Active component or in the Reserves? Answer. Retaining healthcare professionals beyond completion of their initial Health Professions Scholarship Program obligation is both multi-faceted and complex. Although the current economic climate may assist in some regards to some specialties, data from ‘‘exit surveys’’ consistently indicates that the prolonged war efforts in Afghanistan and Iraq and the associated requirement for more frequent and/or extended deployments plays a significant role in influencing whether a service member will remain in uniform beyond his/her initial service commitment. We continue to seek mechanisms to create more pay equity with private sector salaries. New authorities for special pays are helping. 159

To assist in retention of personnel, we also perform active mentorship with the Developmental Team of each Corps. Considering the member’s professional experience, clinical expertise, and preferences for education/training and future assignments, the Corps leadership is able to evaluate their potential as leaders and clinicians and to guide them to future success as a valued Air Force officer and skilled member of the medical team.

NURSE CORPS PROMOTIONS Question. LTG Green, what are the potential adverse effects of the Nurse Corps Chief’s non-sequential promotion from O–6 to O–8? What actions have been considered to mitigate these effects on the Chief of the Nurse Corps? Has any consideration been given to the possibility of allocating an O–7 billet to the Nurse Corps to ensure that the Corps Chief is afforded the opportunity to properly transition to the rank of Major General? Answer. Force developing our colonels and considering only those colonels with 26–29 years of service provides a more seasoned senior officer and decreases the potential for transition challenges. However, we would certainly welcome the opportunity for another pinnacle position for Nurse Corps force development and transition to the second star.

QUESTIONS SUBMITTED BY SENATOR BARBARA A. MIKULSKI

RECRUITMENT OF MENTAL HEALTH PROFESSIONALS Question. DOD has a critical shortage of mental healthcare professionals. During review of the Fort Hood incident where the alleged gunman, Major Hasad, U.S. Army psychologist, is charged with the deaths of 13 victims, reports show discrep- ancies in documentation and counseling as it related to his professional abilities and behavior. Suggestions were made that he was kept on active duty with no negative reprimands because he had diversity as a Muslim to our nation’s service despite his failure to perform. What is DOD doing to recruit more mental health workers and to ensure they are quality healthcare professionals? What are the roadblocks to meeting the shortage of mental health professional? Answer. We are currently assessing new and emerging mental health requirements and determining the best mix and number of mental health providers required to meet future needs. As recruiting fully qualified psychologists, psychiatrists and mental health nurses remains challenging, the Air Force has focused on developing our own pool of mental health professionals. In addition to highly regarded social worker, psychology and psychiatry residencies, we are proposing to establish a mental health nurse training program at Travis Air Force Base, California. Addi- tionally, the Air Force has consolidated our special pay programs to optimize accession and retention incentives. Question. What is being done to reduce the stigma and provide enough care givers so Airmen and their families do not suffer in silence? Answer. The effort to reduce stigma has been part of the suicide prevention program since the program’s inception in 1997. We have shown, and spread the word, that 95 percent of patients self-referring to mental health treatment experience no adverse impact on career or military status such as occupational restrictions or discharge actions based on fitness for duty or security concerns. The numbers of mental health visits have increased steadily over the last 5 years, suggesting a greater willingness for individuals to seek care. In addition, the Air Force has leveraged several resources for non-medical counseling in order to decrease stigma and ease an Airman’s access into less formal counseling settings. Examples include: —Airman and Family Readiness Centers across the Air Force use Military Family Life Counselors, who can see individuals or couples with ‘‘mild’’ problems without the need to document or come in to a clinic. —TRICARE Assistance Program is a pilot project of online counseling available to adult family members and Airmen. —Military OneSource counselors are available for non-medical counseling by self- referral through a toll-free number, also without medical documentation. —In a growing number of Air Force Medical Treatment Facilities, mental health providers are available in primary care to see patients who may not otherwise seek mental healthcare or for those with minor problems such as sleep difficulties which may not require formal mental healthcare. 160

Question. How is Air Force medicine integrated into the suicide prevention programs to ensure mental health services are getting to those who need it before it’s too late? Answer. The Air Force Suicide Prevention Program Manager falls under the Sur- geon General’s office ensuring full engagement of the medical resources in preventing suicide within the service. The Air Force has integrated behavioral health providers within our primary care clinics, allowing our members to access initial mental health services without a separate appointment in a mental health clinic. For many Airmen these initial behavioral health interventions within primary care may be sufficient to address their needs. For others who may require more sustained treatment, initial contacts within primary care serve to ease their concerns and facilitate the transition to traditional mental healthcare. When a suicide does occur, medical providers review all care provided to the individual to look for potential improvements in the Air Force medical system that may prevent similar incidents in the future. Within our primary care system our Airmen complete annual personal health assessments, in addition to health assessments triggered by deployments. The assessments provide an opportunity for our medical providers to identify possible mental health concerns and risk for suicide and refer to mental health services as necessary.

CERVICAL CANCER Question. Cervical Cancer is preventable. In 2009 over 11,000 American women were expected to be diagnosed with cervical cancer and over 4,000 women were expected to die from the disease. More than one-half of women who die from cervical cancer have never been screened or have not been screened in the past 5 years. Human Papillomavirus (HPV) testing is an approved and widely accepted test to search for cells that have the potential of turning cancerous. Research has proven that when performed together with cytology screening, it increases detection of abnormal cell changes by 30 percent. National medical organizations and insurance companies have determined screening of HPV testing and cytology screening at the same time as the standard of care, however TRICARE has deemed HPV testing authorized only after a negative cytology exam. What is Air Force medicine doing to ensure its female patients are receiving the highest quality of cervical cancer screening available? What is the percentage of female patients who receive current standards of screening within the required timeframes? Are HPV tests available at all Air Force military treatment facilities? What is Air Force medicine doing to increase prevention efforts of their female patients from developing cervical cancer? Answers: Just to clarify TRICARE does cover the assessment of women with Atypical Squamous Cells of Undetermined Significance cells detected upon initial pap smear (Source: ‘‘Tricare Policy Manual Pathology and Laboratory Chapter 6 Section 1.1. E. Human Papillomavirus testing’’ (CPT1 procedure codes 87620– 87622)). TRICARE states that human papillomavirus (HPV) testing is authorized after a positive cytology exam. As of December 2009, 81.99 percent of women 24–64 years old (continuously enrolled in a military treatment facility (MTF)) have completed cervical cancer screening in accordance with Healthcare Effectiveness Data and Information Set methodology and the minimum screening recommendations from the American Academy of Family Physicians and the U.S. Preventive Services Task Force. The National Com- mittee for Quality Assurance median score is 82 percent. The U.S. Preventive Serv- ices Task Force (USPSTF) concludes that the evidence is insufficient to recommend for or against the routine use of HPV testing as a primary screening test for cervical cancer. Rationale: The USPSTF found poor evidence to determine the benefits and potential harms of HPV screening as an adjunct or alternative to regular pap smear screening. Trials are underway that should soon clarify the role of HPV testing in cervical cancer screening. Cervical cancer screening is available at all Air Force medical treatment facilities and all Air Force medical facilities send specimens to Wilford Hall for routine screening. HPV testing capabilities includes Reflex HPV testing for specimens showing atypical cells, i.e., ‘‘ASCUS PAP,’’ and direct HPV testing of specimens when ordered by a provider. The Air Force Medical Service utilizes a multi-pronged approach for cervical cancer prevention. HPV vaccination is available to all eligible patients according to Food and Drug Administration guidelines. Health risk assessments (Web HA) are 161 completed as part of the Preventive Health Assessment for Active Duty personnel. The tool identifies individuals at potential risk for sexually transmitted infections (e.g., HPV) and provides risk-reduction messaging ‘‘alerts’’ to patients and healthcare teams. Education and questionnaires on risk factors are addressed during routine clinical visits for all patients. Cervical cancer screening is a focus metric of Air Force Surgeon General Executive Global Look. Cervical cancer screening surveillance/outreach is provided with use of the Military Health System Population Health Portal and provides MTFs provider level reports for cervical cancer screening rates and women overdue. MTFs are able to use this data to encourage patients to remain current on screening guidelines. Cervical cancer screening with availability of HPV testing is available at all MTFs.

QUESTIONS SUBMITTED BY SENATOR PATTY MURRAY

MENTAL HEALTH AWARENESS Question. The Army has partnered with the National Institutes of Mental Health (NIMH) to conduct long-term study of risk and protective factors to inform health promotion and suicide prevention efforts in late 2008. What is the Air Force doing to promote mental health awareness? Answer. The Air Force has implemented wide-ranging efforts to promote mental health awareness and decrease stigma in our service. Many of these efforts have roots in our suicide prevention program, which was launched in 1996. At this time, we marshaled the capabilities of all our helping agencies, mental health, family advocacy, chaplains, family support centers and others within what we called an Inte- grated Delivery System (IDS). The goal continues to be to provide comprehensive efforts at the base level to meet the needs of our communities. Our suicide prevention program created a way for these IDS members to get into our units and talk about issues that stress the force. By bringing these discussions to the units and focusing community efforts in reducing stressors we enhanced awareness of these issues. We integrated suicide prevention within our professional military education to help leaders understand the mental health factors that may contribute and leaders’ roles in addressing these. We have continued to build on these efforts with our personal health assessments, which regularly ask our Airmen about potential mental health needs, and we review responses that indicate risk and make appropriate referrals for care as necessary. The Air Force has published a Leaders’ Guide for Managing Personnel in Distress, which provides straightforward guidance to supervisors and other leaders how to assist their subordinates in accessing the appropriate services. This tool helps leaders see their role in helping to manage the personal needs of their subordinates, and to discuss these issues in a productive manner. We have also developed specific programs for Airmen throughout their careers. The Air Force Landing Gear Program was designed to help Airmen cope with the stressors of deployment and redeployment. This program, which is currently being revised to encompass enhancing resilience for all our Airmen, has been complemented by the creation of Deployment Transition Programs to facilitate the smooth reintegration of our Airmen who have experienced the most stressful deployment experiences. Air Force leadership continues to explore new ways to ensure our Airmen understand that their mental health is as vital to the success of our mission as their physical health. Question. Is the Air Force conducting long-term studies similar to that of the Army and NIMH? Answer. The Air Force has been conducting research on suicide prevention for many years. When the Air Force initiated its comprehensive suicide prevention program in 1996, we partnered with the University of Rochester and Dr. Kerry Knox to carry out research on the effectiveness of these efforts. The first findings of this project were published in the British Medical Journal in 2003 and showed the effectiveness of our suicide prevention initiatives. The results demonstrated that our broad community-based efforts were not only associated with a 33 percent decrease in suicides, but also with decreases in a wide range of other problematic behaviors such as domestic violence, accidental death and homicide. This research led to the AF program being included in the Substance Abuse and Mental Health Services Ad- ministration’s list of the only 10 Evidence Based Practices for the prevention of suicide. The Air Force suicide prevention program has continued this partnership with Dr. Knox, who has another study in press that will show continued compliance with the 162

Air Force suicide prevention program, is associated with continued lower rates of suicide. The Air Force Suicide Prevention Program is also engaged in a number of other studies with researchers at the Uniformed Services University of the Health Sciences to examine case data on past suicides, including data collected through our Suicide Event Surveillance System, and the Department of Defense Suicide Event Report and Personal Health Assessment data to look for factors that may allow us to better identify those at risk for suicide. Recent efforts in this area have allowed us to identify career fields that appear to be at greater risk for suicide, allowing leadership to target additional prevention efforts at these groups. The Air Force has also been collecting data on new recruits entering the Air Force regarding their past behavioral history. This appears to show promise in allowing us to identify, from a recruit’s earliest days in the Air Force, those Airmen who may be at higher risk for a variety of problems. The Air Force is now exploring ways to reach out to these Airmen to improve their ability to cope with the rigors of military life. Finally, the Air Force is in discussion with the Army and National Institutes of Mental Health to see how the Air Force may be able participate in this important study as it moves forward.

FAMILY READINESS AND SUPPORT Question. Family Readiness and support is crucial for the health of the Services. The health, mental health, and welfare of military families, especially the children, has been a concern on mine for many years. This also includes education, living conditions, and available healthcare. Are you meeting the increased demand for healthcare and mental health professionals to support these families? If not, where are the shortfalls? Answer. The Air Force has had an increase in utilization of mental health services over the past 5 years both at the military treatment facilities and through the TRICARE network. In response to this growing use of mental health services, Mili- tary and Family Life Consultants were added at the Airmen and Family Readiness Centers to provide additional non-medical counseling resources for Airmen and their families to address issues such as stress management and relationship issues. In addition, the Air Force added 97 clinical mental health billets to perform clinical duties under the Director of Psychological Health. The Air Force also has hired 32 full time Behavioral Health providers to embed in primary care clinics to facilitate mental health treatment in the primary care setting. Question. What improvements have been made with respect to the children of Air- men and meeting their special requirements? Answer. In fiscal year 2009, 1,926 Air Force families received Family Advocacy Strength-Based Therapy Service (FAST Service). FAST is a family maltreatment prevention service for families who do not have a maltreatment incident but have risk factors for domestic/child maltreatment. Also, the New Parent Support Program (NPSP) services focus on providing education and support to military families related to pregnancy, infant/toddler care, growth and development, and safety. Guid- ance in the areas of parenting, couple communication and conflict management are provided. Emphasis is placed on assisting families with young children to deal with military lifestyle challenges, with particular emphasis on support before, during and after deployment. The Air Force NPSP screened 13,766 military families for risk of child and/or partner maltreatment in fiscal year 2009. During fiscal year 2008, 13,561 families were screened. During 2009, 18,608 home visits by Registered Nurses and Medical Social Workers were provided to NPSP families, an increase from the 17,470 home visits provided during fiscal year 2008. Services are provided with the goal of preventing child and partner maltreatment. In 2009, 97 percent of families who were at high risk for family maltreatment and received home visitation services did not have a substantiated child maltreatment case in the year following closure. The Air Force Medical Operations Agency is in the process of standing up a cell to coordinate medical support to families with special needs across the Air Force. The Special Needs Cell will track families with special needs and focus on their medical support during permanent change of station moves. Question. What programs have you implemented to assist the children with coping with frequent deployments, re-integration, and other stresses of military families? Answer. Air Force Family Readiness Centers provide assistance to families before, during and after deployments. The programs include advice for parents on talking to their children about deployment and anticipating the concerns of children during deployment. The centers also provide video communication with deployed family 163 members and other support services. The three Services have established the Uni- formed Services Chapter of the American Academy of Pediatrics (AAP). Their website contains an entire section devoted to support of military families. The AAP Military Youth Deployment Support Website has been designed to support military youth, families, and the youth-serving professionals caring for this population (http://www.aap.org/sections/uniformedservices/deployment/index.html). Videos, patient handouts, provider information, blogging website and many more resources are devoted to this area. There are many additional websites and services helpful to military families. A short list is provided below. Resources for Parents include the following Web Sites: Military OneSource, Na- tional Military Family Association, Military Homefront, Military Child Education Coalition, Zero to Three Organization, Hooh4Health, USA4militaryfamilies.org, and Stompproject.org.

WOUNDED WARRIOR CARE Question. In the recently released Department of Defense budget guidance, it states that ‘‘caring for our wounded warriors is our highest priority: through improving health benefits, establishing centers of excellence, and wounded warrior initiatives.’’ What systems do you have to ensure the transition of wounded warriors from De- partment of Defense to the Department of Veterans Affairs is completed without unnecessary problems? Answer. The Air Force has created the Warrior and Survivor Care office which oversees the Air Force Survivor Assistance Program, the Air Force Recovery Coordi- nation Program, and the Air Force Wounded Warrior program in order to maintain continual contact with the wounded, ill or injured Airman and his or her family throughout the entire recovery, rehabilitation, and reintegration process. Profes- sional staff from these programs provides oversight during the member’s transition to ensure the recovering service member receives all military and external agencies’ benefits and entitlements. The Air Force Survivor Assistance Program (AFSAP) is designed to marshal all available resources in support of family needs when an Air- man becomes seriously wounded, ill or injured, or when an Airman dies while on active duty. At the same time, the AFSAP also provides a systematic structure through which offers of assistance, information and support are made available on the family’s terms. The Recovery Coordination Program was designed to address reforms to existing processes within the Department of Defense and the Department of Veterans Affairs (VA). It improves the uniformity and effectiveness of care, management and transition across the Military Departments, as well as transfers to VA Medical Cen- ters, Polytrauma Rehabilitation Centers and civilian providers, through the use of standardized policies, processes, personnel programs and tools. The Air Force Wounded Warrior Program, through the base-level Airman and Family Readiness Centers, provide enhanced transition assistance services that include one-on-one pre-separation counseling, one-on-one VA benefits and Disabled Transition Assistance Program, and personal assistance in completing and submitting a VA disability claim. Approximately 70 percent of our Air Force Wounded Warrior Program participants suffer from post traumatic stress disorder or other mental health conditions. Many of them also have residual physical problems. We provide ongoing needs assessments pre and post separation to ensure they receive the benefits, entitlements and care they earned. An Information Sharing Initiative is being designed for the sole purpose of ensuring flawless transition and exchange of data between DOD entities and the VA. The DOD-mandated working group is in the early stages of requirements development, and will provide a significant improvement to the Air Forces tracking of wounded, ill, and injured service members. This will result in a refined and simplified transition with uninterrupted medical and non-medical care and support to our Airmen and their families. Question. What do you consider a successful transition and do you follow-up with the Service members to ensure there are no problems even after they have been released from Active Duty? Answer. We consider a successful transition when several factors converge to stabilize the wounded, ill or injured Airman and his or her family. This includes continuum of medical care for the member, with no interruptions in care, including continuation of medication; stabilization of family finances, to include receipt of Depart- ment of Veterans Affairs disability compensation, military retired pay if retired, or accurate severance pay, if separated. Awareness of benefits and entitlements, and timely and accurate receipt of those benefits plays a big role in the psychological health and perception of the member and his or her family. 164

Transition is also considered successful when the member and family receive and act on the information provided to meet their personal goals, whether it is to continue working or pursue higher education. We believe that the most successful transitions start at the beginning of the Medical Evaluation Board process and continue through the transition process. The key factor is to keep the member and family informed of what to expect and to normalize their experiences as much as possible. Family integration into the transition process is an important ingredient for a successful transition. The Air Force Wounded Warrior Program staff is in continual contact with Air- men and their families during the entire process. During the transition process, the wounded warrior counselors coordinate all transition actions between the Air Force and the Department of Veterans Affairs, including disability compensation. Ongoing contacts with the member and family provide the counselors with needs reassessments to ensure all benefits and entitlements are on track even after discharge.

RESERVE COMPONENTS Question. The Reserves and particularly the National Guard have unique concerns while deployed. It would seem as though there are no near term plans to dis- continue the use of our Reserve Component in Iraq and Afghanistan. How are you determining budget requirements to accommodate the Reserve Com- ponent as they need Department of Defense healthcare well into the future? Answer. Medical care for deployed personnel, to include Reserve Component members, is a joint effort, and the Total Force receives the full spectrum of care to ensure members remain healthy and resilient. As a part of the Joint Team, the Air Force contributes comprehensive medical capabilities at both home station and in the deployed environment. Defense Health Program budget requirements for the Air Force Medical Service are coordinated with and resourced by the TRICARE Manage- ment Activity. Key drivers for resourcing include population projections and expected workload. Healthcare workload attributed to Reserve Component members and dependents is accounted for by the Air Force Medical Service. In addition, the fiscal year 2010 President’s budget and fiscal year 2011 President’s budget requests provided additional resources for wounded, ill, and injured and other enduring healthcare requirements resulting from Overseas Contingency Operations.

MENTAL HEALTH CARE Question. General Casey recently stated the number of Army soldiers who feel there is a stigma for seeking mental healthcare has been reduced from 80 to 50 percent. This is a significant improvement, but there is more work to be done. Despite the reduced number of those who feel there is a stigma, are more service members coming forward to seek treatment? Answer. The Air Force believes that we have seen some success in efforts to decrease the stigma of seeking mental health services. Despite a slight decrease in the strength of our force since 2003 the Air Force has seen a steady increase in the utilization of our of uniformed mental health services. Since 2003 the number of active duty visits to our mental health clinics has increased from 226,000 visits to over 300,000 visits annually. While some of these visits may be associated with screenings for activities such as deployments and security or special duty clear- ances, the overall trend indicates a greater willingness in our Airmen to seek mental healthcare within our system. Question. What actions are the Services taking to continue to reduce the stigma and encourage Service members to seek treatment? Answer. Major steps the Air Force has taken include: Actively working to decrease stigma through statements from senior leaders encouraging all Airmen to seek help when needed and through efforts to counter myths related to mental health treatment within the Air Force. As part of the annual suicide prevention training, Airmen are presented with data showing that the vast majority of those who self-refer to mental health experience no adverse outcome and their confidentiality is maintained. This is presented to encourage Airmen to seek help early before stress or mental health problems increase to the point that a command directed referral maybe necessary. Conducting an annual ‘‘Wingman Day’’ at each base. These activities focus on the role all Airmen play in being a Wingman, that is, caring for their fellow Airmen. Wingman day is an opportunity to review the importance of teamwork and helping fellow Airmen perform their best. This includes helping Airmen realize when they may need help and facilitating access to that care. Integrating behavioral health providers within our primary care clinics, allowing our members to access initial mental health services without a separate appoint- 165 ment in a mental health clinic. For many Airmen, these initial behavioral health interventions within primary care may be sufficient to address their needs. For others who may require more sustained treatment, initial contacts within primary care serve to ease their concerns and facilitate the transition to traditional mental healthcare. Publishing a Leaders’ Guide for Managing Personnel in Distress provides straightforward guidance to supervisors and other leaders on how to assist their subordinates in accessing the appropriate services. Establishing Directors of Psychological Health at each base to serve as a consultant to leaders at the base level in addressing the mental health needs present in the community. Establishing policy to provide greater confidentiality to those Airmen under investigation who are also at risk for suicide. This limited privilege suicide prevention program ensures Airmen under investigation and deemed to be at risk for suicide are protected from information shared in the context of their mental health treatment being used against them in court or in the characterization of discharge. Question. Does your plan include the mental health of families, and if so what is that plan? Answer. The mental health of families is of significant concern to the Air Force as family support is essential for effective functioning of our service members. In response to this need for family services, the Air Force added Military and Family Life Consultants at the Airmen and Family Readiness Centers to provide additional non-medical counseling resources for Airmen and their families to address issues such as stress management and relationship issues. In addition, the Air Force added 97 clinical mental health billets to perform clinical duties under the Director of Psychological Health allowing increased access to care services at the military treatment facilities. The Air Force has also hired 32 full-time behavioral health providers to embed in primary care clinics to facilitate mental health treatment in the primary care setting. In addition to traditional mental health clinic services, the Air Force Family Advocacy program offers Family Ad- vocacy Strength-Based Therapy Service (FAST Service). FAST is a family maltreatment prevention service for families who do not have a maltreatment incident but have risk factors for domestic/child maltreatment. Also in Family Advocacy, the New Parent Support Program services focus on providing education and support to military families related to pregnancy, infant/toddler care, growth and development, and safety. Guidance is provided in the areas of parenting, couple communication and conflict management. Emphasis is placed on assisting families with young children to deal with military life-style challenges, with particular emphasis on support before, during and after deployment. Military One Source and the Web-based TRICARE Assist- ance Program are also available for families to utilize for support.

QUESTION SUBMITTED BY SENATOR THAD COCHRAN

JOINT VENTURE KEESLER-BILOXI MEDICAL SYSTEM Question. General Green, the Department of Defense and the Department of Vet- erans Affairs are establishing joint ventures in hospitals that are co-located around the country, in hopes to achieve efficiencies with combined personnel and shared resources, thus eliminating duplication. Currently, as you know, the Navy and the VA are working on a joint venture in North Chicago, where the plan is to operate the facility with a single civilian staff under the VA, operating out of one combined facility. The Air Force and the VA are also working toward a joint-venture between Keesler and Biloxi, but have adopted a different model than the North Chicago model. I understand the Air Force has stated that not every joint venture will be applicable to every location, and thus the Air Force is not inclined to follow the North Chicago model. One of these reasons might be due to the different mission focus between the two locales. For example, the North Chicago facility supports mostly non-deployable personnel (Navy recruits) and serves as a schoolhouse for medical trainees. In Keesler, many of the medical Airmen deploy in their respective Air Expeditionary Force rotations (AEF) and for humanitarian missions, as needed. General, can you please give your thoughts on the other reasons as to why the current model at Keesler-Biloxi has been so successful and why it is the best model for the Gulf Coast region? Also, are there other Air Force-VA joint venture locations where you think this model is more applicable to improve treatment efficiency and provide quality care? 166

Answer. The joint venture between the 81st Medical Group, Keesler AFB, Mis- sissippi, and the Gulf Coast Veteran Affairs Health Care System, Biloxi, Mississippi, is relatively new and not yet complete, so assessing their successes at this time is difficult. However, despite the fact they are still in the process of integrating and moving some services, their centers of excellence model is already showing signs of success. Success for this joint venture, as well as any other joint venture model, is largely based on a willingness to work together to ensure the organization keeps the patient’s needs as priority one. Communication and commitment to success is essential at all levels of the organization, especially with senior leadership. This commitment is very obvious at the Keesler/Biloxi joint venture as the leaders from both sites are very involved in the operation of the joint venture. Another key factor to success is a commitment to provide services for the other partner that they need for their patient population in the facility vice sending them out to the network— this is true for all partners in the joint venture. An excellent example is the Depart- ment of Veterans Affairs providing inpatient mental health services for Department of Defense beneficiaries, and Department of Defense providing women’s health services for Department of Veterans Affairs’ beneficiaries.

QUESTION SUBMITTED BY SENATOR ROBERT F. BENNETT

CHIROPRACTIC CARE Question. I’m pleased that TRICARE has worked over the past few years to expand chiropractic care for service members. Indeed, I have heard one of the top complaints of returning soldiers has been the type of neck and back pain chiropractic care would seemingly address. Unfortunately, our servicemen and women from Utah (particularly Hill AFB) are not able to receive this beneficial service that they have been promised because of the lack of approved providers. Shouldn’t all soldiers have an opportunity to receive promised care? What alternatives for chiropractic care are available to airmen and soldiers, such as allowing them to receive private care, the cost of which would be reimbursed for those who are not within 50 miles of such a center, or are unable to be seen within 30 days? Answer. The Chiropractic Health Care Program is available to Active Duty service members (including activated National Guard and Reserve members) at designated military treatment facilities (MTFs) throughout the United States. This program is currently offered at 60 designated MTFs throughout the United States. There is currently no expansion set for 2010. The Department of Defense considers this program fully implemented, however, if directed to expand by Congress, the Air Force would certainly consider places such as Hill AFB, Utah. Alternatives to chiropractic care are non-chiropractic healthcare services in the Military Health System (e.g., physical therapy or orthopedics), referred care when care not available in a timely fashion at the MTF, or to seek chiropractic care in the local community at their own expense. Chiropractic care received outside of the designated locations is not covered under the Chiropractic Health Care Program. Major Air Force locations offering chiropractic care are listed below: Andrews Air Force Base Luke Air Force Base Barksdale Air Force Base MacDill Air Force Base Davis-Monthan Air Force Base Maxwell Air Force Base Eglin Air Force Base McGuire Air Force Base Elmendorf Air Force Base Offutt Air Force Base Hurlburt Field Scott Air Force Base Keesler Air Force Base Tinker Air Force Base Kirtland Air Force Base Travis Air Force Base Lackland Air Force Base U.S. Air Force Academy Langley Air Force Base Wright Patterson Air Force Base

QUESTIONS SUBMITTED TO REAR ADMIRAL KAREN FLAHERTY

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

BEHAVIORAL HEALTH PROVIDERS Question. Admiral Flaherty, what innovative, multidisciplinary efforts has the Navy implemented to increase access to behavioral health providers? Answer. Increasing access to care for Behavioral Health remains a top priority for Navy Medicine. Prior ‘‘innovations’’ that have now become the norm include oper- 167 ationally embedded mental health providers, integration of Mental Health Care into primary care, Psychological Health Outreach Coordinators and use of our Deploy- ment Health Centers as destigmatizing portals of care. Current innovation efforts are focusing on the use of intensive, outpatient, multidisciplinary group sessions for the treatment of Post Traumatic Stress Disorder (PTSD) and combat related mental health issues. One example of this type of innovative program is the ‘‘Back on Track’’ program at Naval Hospital Camp Lejeune. This 2 week program is built on the foundation of our Operational Stress Control (OSC) curriculum and outcome measures from the program are demonstrating statistically significant decreases in depression symptoms. Another innovative program is the multidisciplinary team assessment of every patient that is medically evacuated from theater to identify potential cognitive and mental health issues. Access is increased in a non-stigmatizing manner by providing this assessment to all patients without need for consult or self- referral. Follow on care is provided as indicated utilizing all members of the multidisciplinary team.

DEPARTMENT-WIDE NURSE RESIDENCY PROGRAM Question. Admiral Flaherty, I understand that the civilian nursing community has established nurse residency programs in order to better prepare new graduates and novice nurses to care for more complex patients. I am also aware that each military service has implemented similar nurse intern and transition programs. Has there been any consideration on the development of a Department wide Nurse Resi- dency Program? Answer. The Navy Nurse Corps has Nurse Intern Programs designed to mentor and train new graduates at our three largest medical centers (Naval Medical Center Portsmouth, Naval Medical Center San Diego, and the National Naval Medical Cen- ter) and at Naval Hospital Jacksonville. These programs are designed to orient recent graduate and registered nurses with limited clinical experience to the role of professional nursing. Training consists of classroom lectures, simulation lab, seminars, and hands on clinical experience. Classroom subject matter includes physical assessment, pathophysiology, diagnosis, nursing interventions, and general military training. Participants have direct patient care contact in the hospital setting. As medical treatment facilities within DOD merge, I think it is wise for the services to compare core curriculum and outcomes of their programs and blend best practice into a standardized program across the Department of Defense, while allowing for local leeway of program specifics based on individual needs of the local facility.

NAVY NURSE CHALLENGES AT FHCC Question. Admiral Flaherty, what are the major challenges facing Navy nurses as we move to a joint medical facility with the VA in Chicago, Illinois and how are the two Departments coordinating efforts to eliminate them before this facility becomes operation in the fall of 2010? Answer. The nursing leadership in both communities has held multiple joint meetings over the past 18 months to communicate information and ideas on issues surrounding the Veteran’s Administration (VA)—Navy merge of the joint facility in Chicago, Illinois. Action items have focused on credentialing and privileging, the setting of nursing standards, and staff education and training. We are educating the VA about the skill set of Hospital Corpsman and have joined each other’s Executive Committee of the Nursing Staff (ECONS), and are merging toward a joint committee. Last, we are merging the Plan for Provision of Nursing Care between the VA’s plan while adding Navy specific components. We are excited about the future possibilities and look forward to sharing our success with others.

NAVY NURSE RECRUITING MECHANISMS Question. Admiral Flaherty, what are some of the best mechanisms that the Navy has instituted for recruitment and retention that might be beneficial for all services? Answer. Retaining Navy Nurses is one of my top priorities. Key efforts that have positively impacted retention include the Registered Nurse Incentive Specialty Pay (RN–ISP), a targeted bonus program for undermanned clinical nursing specialties and highly deployed Nurse Practitioners, graduate education programs through Duty Under Instruction (DUINS), and the Health Professions Loan Repayment Pro- gram (HPLRP) for baccalaureate nursing education, which assists nurses in reducing their student loan debt. The Navy Nurse Corps includes both uniformed and civilian professionals. In recent years, we have implemented two very exciting programs to incentivize our civilian nurses to work and stay working as Navy Nurses. Civilian nurses are now allowed to attend the Perioperative Nurse Training Program which will train them 168 for a new career as Operating Room Nurses. We also introduced the Graduate Pro- gram for Federal Civilian Registered Nurses. This program provides opportunities for civilian nurses to obtain a graduate degree in nursing while receiving full pay and benefits of their permanent nursing position. Nurses selected for this program must have served at least 3 years in the Federal civilian service at a Navy Medicine activity prior to applying. While in graduate school they work a compressed work schedule while participating in full-time graduate education. We are confident that these two innovative programs will work to both recruit and incentivize civilian nurses to stay employed as Navy Nurses.

NAVY NURSE CORPS COLLABORATION WITH VA Question. Admiral Flaherty, has the Navy Nurse Corps engaged in any collaborative nursing research efforts with the Veteran’s Administration? Answer. Yes, one of my Nurse Researchers, Captain Patricia Kelley, is the Prin- cipal Investigator on a study titled ‘‘Clinical Knowledge Development: Continuity of Care for War Injured Service Member.’’ The purpose of this research study is to gather first person accounts of how nurses learn to care for wounded service members along with service members’ memories of their care. This study will obtain interviews from over 250 nurses and 50 injured service members at military hospitals and Veterans Administration Medical Centers. From this study we hope to expand the nurse’s understanding of care for the wounded warrior. I am pleased to report that this study was funded by the TriService Nursing Research Program (TSNRP).

QUESTION SUBMITTED BY SENATOR THAD COCHRAN

RESILIENCY IN THE FORCE Question. Admiral Flaherty, the Navy is in the process of ‘‘rebalancing’’ the force to reduce battle fatigue from multiple deployments and give service members a chance to ‘‘reset’’ mentally and physically in a time of high operational tempo. Spe- cific programs within the Navy include ‘‘FIT’’ for right-sizing the force and the Oper- ational Stress Control Program. These programs require a great deal of support from medical units within each respective Service. The concern is that while implementing these programs, the high demand, low density medical career fields will remain stressed and unable to reset, as well. Admiral, can you please comment on if these programs have increased the demand on your nursing corps? Can you also comment on if these same programs are effective in helping medical personnel reset, also? Answer. The Navy’s Operational Stress Control (OSC) program and the United States Marine Corps Combat Operational Stress Control (COSC) programs are line- owned and line-led programs. They focus on leader’s responsibilities for building resilient Sailors, Marines, units, and facilities, mitigating the stigma association with seeking psychological healthcare, and promote early recognition of troublesome stress reactions before they develop into stress injuries or illness. Navy Medicine, to include the Navy Nurse Corps, plays a supporting role. Both programs are built on the time-proven leadership continuum and have formal curriculum being delivered at various points throughout a Sailor’s or Marine’s career. Navy Fleet and Family Support Centers and Marine Corps Community Services are contributing heavily to the Family OSC/COSC modules. Stress unique to our caregivers, such as compassion fatigue and burnout, requires a more dedicated approach. Navy Medicine has developed the Caregiver Occupa- tional Stress Control (CgOSC) program with the core objectives of early recognition of caregivers in distress; breaking the code of silence related to occupational stress reactions and injuries, and engaging caregivers in early help as needed to maintain mission and personal readiness. The concept of ‘‘caregiver’’ in this context refers to medical personnel (from corpsmen to physicians), clinically and non-clinically trained chaplains, religious program specialists, and family service professionals working within Navy Medicine. The Navy OSC, COSC and CgOSC programs actually enhance Navy Nurses as clinical leaders by leveraging a common framework for recognizing and responding to operational and occupational stress injuries. The increased demand by these programs on the Navy Nurse Corps is negligible because of the foundation of patient and staff education that is a core competency for all Navy Nurses. Anecdotally, we have seen our mid-grade nurses and Hospital Corps- men rapidly integrate the principles of stress first-aid into their cores skills in a way that enhances their ability to address patient, family, and peer psychological dis- 169 tress. Their increased competency and skill used when providing complex and challenging care contributes to compassion satisfaction which buffers the adverse effects of compassion, fatigue and burnout.

QUESTIONS SUBMITTED TO MAJOR GENERAL KIMBERLY SINISCALCHI

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

O–7 AIR FORCE NURSE CORPS BILLET Question. Major General Siniscalchi, how would the addition of a O–7 billet benefit the Air Force Nurse Corps? Answer. It would provide an additional force development opportunity for the Air Force Nurse Corps. However, all five Corps within the Air Force Medical Service have general officer billets for force development. An added star for the Nurse Corps should not be at the expense of another Corps.

NURSE RESILIENCY Question. Major General Siniscalchi, as nurses continue to deploy in support of service members world-wide, what efforts has the Nurse Corps made to ensure that we are also caring for our caregivers and instilling resiliency in our nurses? Answer. The Air Force has continued to monitor the well-being of all Airmen through multiple measures. Among these measures are our Post-Deployment Health Assessments (PDHAs) and Post-Deployment Health Reassessments (PDHRAs) administered following a deployment. Medical career groups (including nurses) are among the top three career groups for self-reported symptoms of post-traumatic stress on PDHA/PDHRA. Air Force leadership supported Lt. Gen. Green’s plans to provide targeted, tiered Resiliency Training for higher-risk career groups including the formation of a Deployment Transition Center (DTC) in United States Air Forces in Europe. The DTC is a 2-day resiliency training and decompression stop on a deploying Airman’s way home. Included in the 2-day training are JET Airmen and other medics who participate in ‘‘outside-the-wire’’ missions. In addition to the DTC, plans are underway for enhanced pre and post deployment resiliency training for these groups and targeted interventions for high risk groups, with enhanced small group or face to face training. Finally, medics at both Bagram and Balad have a high exposure rate to injury and death, and plans are to implement a resiliency program based on the mortuary affairs model at Dover Air Force Base, Delaware integrating physical, spiritual, social, and psychological resiliency across their deployment.

CIVILIAN NURSE TRANSITION PROGRAMS Question. Major General Siniscalchi, I understand that the Air Force has established collaborative agreements with several civilian nurse transitions programs. Has any consideration been given to partnering with the Army or Navy Transition programs? Answer. Consideration has been given; however, we have not ‘‘formally’’ partnered with the Army or Navy nurse residency/transition programs. We have chartered a working group to evaluate our Air Force Nurse Transition Program platform and compare and contrast our program with the Army, Navy and civilian nurse residencies/transition programs. We have an ongoing study to evaluate the performance and effectiveness of our Nurse Transition Programs and to identify potential opportunities for Tri-Service nurse training consolidation efforts.

JOINT MEDICAL POLICIES Question. Major General Siniscalchi, as the military moves toward more joint medical treatment facilities among the tri-services and the Department of Veterans Affairs, do you see a future in merging Nurse Corps policies for governance, education, training, and the provision of nursing care? Answer. At those locations that have tri-service and Department of Veterans Af- fairs nursing, there are opportunities to establish tri-service/Veterans Affairs nursing teams to collaborate efforts for governance, policy development, education and training and the plan for the provision of nursing care. It is, as always, important to note that patient care and advocating for the patient and their family remain a key nursing focus in whatever uniform or setting. There are many similarities in providing nursing care and the emphasis the Services place on the use of Profes- sional Organization policies, education/training and nursing care guidance is a key 170 link to those similarities. Currently we have tri-service teams in Joint Task Force National Capital Region Medical which are working toward a collaborative approach in providing standardized orientation, education and training of our enlisted medics.

NURSE CORPS RETENTION Question. Major General Siniscalchi, despite well known shortages in the nursing profession, I see that all three corps expects to meet or exceed their recruiting goals this year. How does the Air Force plan to retain these nurses for follow on tours as the economy improves? Answer. For those nurses joining the Air Force due to the current economy, we are confident the reasons that made the Air Force an attractive option will also be the reasons they would continue to serve as the economy improves. Initial accessions for fiscal year 2010 consistently speak in positive terms about the benefits of funded graduate education opportunities, professional and collegial relationships within the healthcare team, retirement pension, and continuity for seniority with assignment moves, opportunity for travel and the Air Force as great way of life for their families and children. As we look at retention of our current Air Force nurses, the number of nurses leaving the Air Force in 2009 was the lowest since 2002. Addi- tionally, of the nurses who separate from the Air Force, over one-half are separating to retire after reaching retirement eligibility. In 2009, 59 percent of the nurses who left active duty did so after serving at least 20 years in uniform. With special pay programs such as the Nurse Corps Incentive Special Pay started in fiscal year 2009 to recognize advanced clinical and educational preparation, we hope to see an added benefit of increased retention.

AIR FORCE NURSING RESEARCH INITIATIVES Question. Major General Siniscalchi, what are some of the Air Force Nursing Re- search Initiatives that focus on the specific needs of combat veterans? Answer. Areas of research conducted by the U.S. military in Afghanistan and Iraq have led to advancements in combat casualty medical care and therapies to include tourniquet application, combat gauze, life-saving interventions, en-route care, resuscitation, blood product administration, burns, wound care, post traumatic stress disorder, traumatic brain injury and infectious diseases.

QUESTIONS SUBMITTED BY SENATOR PATTY MURRAY

NURSE CORPS CONTRIBUTIONS Question. Nurses significantly contribute to the healthcare of our Service members and their families. It is important that we maintain appropriate levels of highly trained nurses capable of performing a wide range of healthcare functions. With the maintained high operations tempo of combat in Iraq and Afghanistan, and the increasing requirements for healthcare for the Service member and their families, are you able to maintain the required level of nurses? Answer. Recruiting fully qualified nurses continues to be a challenge. Historical and current statistics tell us this will be an issue for years to come. In fiscal year 2009, we accessed 284 nurses against our total accession goal of 350 (81 percent), down 12 percent from what I reported the previous year. Currently, the recruiting of novice nurses has been successful. At present our recruitment of novice nurses is at 166 percent of our projected fiscal year 2010 goal. While the recruitment of novice nurses is going well, the limiting factor is their depth of clinical experience. Our Nurse Transition Program advances the clinical skills of these new nurses through direct patient care under the supervision of seasoned nurse preceptors. Question. Are there enough nurses entering the military to ensure quality of care for the Service members and to maintain the legacy of superb leadership in the future? Answer. Recruiting fully qualified nurses continues to be a challenge. Historical and current statistics tell us this will be an issue for years to come. In fiscal year 2009, we accessed 284 nurses against our total accession goal of 350 (81 percent), down 12 percent from what I reported the previous year. Currently, the recruiting of novice nurses has been successful. At present our recruitment of novice nurses is at 166 percent of our projected fiscal year 2010 goal. While the recruitment of novice nurses is going well, the limiting factor is their depth of clinical experience. Our Nurse Transition Program advances the clinical skills of these new nurses through direct patient care under the supervision of seasoned nurse preceptors. Question. What are you doing to prepare nurses for senior leadership roles and responsibilities? 171

Answer. We grow our future leaders through professional military education, encouraging certification in clinical specialties, advanced academic preparation and deliberate force development.

QUESTION SUBMITTED BY SENATOR THAD COCHRAN

RESILIENCY OF THE FORCE Question. General Siniscalchi, the Air Force continues to ‘‘rebalance’’ the force to reduce battle fatigue from multiple deployments and give service members a chance to ‘‘reset’’ mentally and physically in a time of high operational tempo. The Air Force continues to work toward Total Force Integration (TFI) to provide the best support possible in a variety of missions world-wide. Multiple deployments, however, do increase the mental and physical stress on the Airman, and many programs have been created in a short time to address these concerns. However, these programs require a great deal of support from medical units within each respective Service. The concern is that while implementing these programs, the high demand, low density medical career fields will remain stressed and unable to reset, as well. General Siniscalchi, can you please comment on if these programs have increased the demand on your nursing corps? Can you also comment on if these same programs are effective in helping medical personnel reset, also? Answer. At this time we have not experienced an increased demand on the Air Force Nurse Corps as a result of current programs. However, we will continue to assess requirements as new initiatives such as Deployment Transition Centers come to fruition.

SUBCOMMITTEE RECESS Chairman INOUYE. Our next hearing of the Defense Appropria- tions Subcommittee will be on Wednesday, March 17, at 10:30 a.m., and at that time we’ll receive testimony from the Navy and Marine Corps. And we’ll stand in recess. [Whereupon, at 12:18 p.m., Wednesday, March 10, the subcommittee was recessed, to reconvene at 10:30 a.m., Wednesday, March 17.]

DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, MARCH 17, 2010

U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10:28 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) presiding. Present: Senators Inouye, Kohl, Cochran, Bond, and Shelby. DEPARTMENT OF DEFENSE

DEPARTMENT OF THE NAVY

OFFICE OF THE SECRETARY

STATEMENT OF HON. RAY MABUS, SECRETARY OF THE NAVY

OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. The hearing will come to order. The subcommittee meets this morning to receive testimony on the fiscal year 2011 budget request for the U.S. Navy and Marine Corps. And I’m pleased to welcome the Secretary of the Navy, Mr. Ray Mabus, the Chief of Naval Operations (CNO), Admiral Gary Roughead, and the Commandant of the Marine Corps, General James Conway. And I look forward to their testimony. The President’s request includes $160.6 billion to pay for the personnel, operation and maintenance, and acquisition programs of the Navy and Marine Corps. The request also includes $18.5 billion to pay for operations in Iraq and Afghanistan in 2011, and $3.8 billion to cover the additional costs of the surge in Afghanistan this year. The subcommittee will hold a separate hearing on March 25 to examine the 2010 surge supplemental request in more detail. The Navy and Marine Corps continue to be standard-bearers in this country’s ability to project power and maintain regional stability. Today, sailors and marines are serving on the front lines in Iraq and Afghanistan. Every day, these men and women are working to support our troops in harm’s way, train foreign security forces, and carry out dangerous combat missions. In addition, our forward presence in the Asia Pacific, the Middle East, and Caribbean and elsewhere, serves to assure our friends and our allies, as well as deter possible adversaries. Our forward (173) 174 bases and ships at sea keep trade routes secure, ease regional tensions, and respond to humanitarian emergencies. I particularly commend the lifesaving efforts of our military personnel after the devastating earthquake in Haiti. As the subcommittee reviews the fiscal year 2011 budget request, it is clear that the Navy and Marine Corps will continue to deal with a number of challenges, particularly with the expensive acquisition programs. Delays in programs like the Joint Strike Fighter (JSF), the CH–53K helicopter, and the expeditionary fighting vehicle can force modernization funds to be used for sustaining older capabilities, in addition to the increased development and procurement costs. Congress will continue to exercise close oversight on balancing the investment in future capabilities with the demand to sustain current equipment. The subcommittee will also have important questions about the plans for shipbuilding. The Navy has initiated work on the next- generation ballistic missile submarine, which includes a major research and development program and a per-ship cost of approximately $7 billion. But, long-range estimates of the shipbuilding budget expect it to average $16 billion over the next 30 years. Many are concerned about the pressure the submarine will place on shipbuilding budgets beginning 10 years from now. Also in shipbuilding, the Navy is committed to a new acquisition strategy for the littoral combat ship (LCS) that emphasizes competition to bring down costs while providing the best capability. With all the recent criticism of earmarks in the newspapers, it is important to know that the Navy would not be able to pursue the new acquisition strategy this year if the Appropriations Committee had not added $60 million in unauthorized funds to last year’s budget. I believe, when the history of this program is written, these additional funds by Congress will result in substantial savings to the U.S. taxpayer. Finally, I’d like to commend the witnesses on their commitment to supporting the needs of sailors and marines who serve our country. Both the Navy and Marine Corps are experiencing very strong rates of recruiting and retention, and I would hope that our witnesses will elaborate, in their opening statement, on the initiatives to take care of our men and our women in uniform. And the full statements of each of the witnesses will be made part of the official record. And now, I am pleased and honored to turn to the vice chairman of the subcommittee, Senator Cochran. STATEMENT OF SENATOR THAD COCHRAN Senator COCHRAN. Mr. Chairman, thank you very much. I’m pleased to join you in welcoming this distinguished panel of witnesses to discuss the budget request for the U.S. Navy and Ma- rine Corps in the next fiscal year. It’s particularly good to see my friend Secretary Ray Mabus, Sec- retary of the Navy, who is serving with distinction in that capacity and served as our Governor of Mississippi and is a good friend. We’re glad to see him in this very important position. And we look forward to hearing your testimony and assure you that we want to do what we need to do here to provide the funding 175 so that we maintain a strong, mobile, and effective Navy and Ma- rine Corps team to protect the security interests of our great country. Chairman INOUYE. Senator Bond, would you care to read a statement? STATEMENT OF SENATOR CHRISTOPHER S. BOND Senator BOND. Thank you very much, Mr. Chairman, Senator Cochran. And thank you, Mr. Chairman, for your concise description of how this subcommittee has provided vitally needed assistance to all branches of the service; and without it we’d have had many shortfalls. But, we welcome Secretary Mabus, Admiral Roughead, General Conway, for appearing before this subcommittee today. I’m particularly interested in our Nation’s carrier fleet, the backbone of our military’s ability to project power and peace around the world. As we all know, the F/A–18 Hornets and Super Hornets are the backbone of the carrier-based strike fighter aviation fleet. These aircraft are providing support for our warfighters, to close air-support mission, to ground forces, with an unmatched deterrent capability. The F/A–18 continues to be the Navy’s only strike fighter with advanced air-to-ground and air-to-air operational capability; and the continued procurement of these aircraft is, I believe, very necessary to address the Navy shortfall. In other words, to apply Secretary Gates’s statement, I think procuring F/A–18s is absolutely necessary. Secretary Gates said that he was ‘‘advocating a shift away from 99 percent exclusive service- centric platforms that are so costly and so complex that they take forever to build, and only then, in very limited quantities. With the pace of technological and geopolitical change and the range of possible contingencies, we must look more to the 80 percent solution, a multiservice solution that can be produced in time, on budget, and in significant numbers. As Stalin once said, ‘quantity has a quality all of its own’ ’’. I think Secretary Gates has hit it on the head. Keeping Ameri- cans, whether our troops fighting overseas or our families at home, safe from current and emerging threats is a difficult challenge in an uncertain and dangerous world. America must have the right tools to meet this challenge. And I believe having a Super Hornet in our arsenal is an important part of the strategy. I applaud the efforts of the Department of the Navy for considering a multiyear procurement. This prudent move would prevent the Navy from having empty carrier decks, save hundreds of millions of valuable taxpayer dollars, and maintain the strength of the United States industrial defense base, a very important objective for the Navy, for the marines, and for the peace and security that this Nation advocates and promotes, here and abroad. Thank you, Mr. Chairman. Chairman INOUYE. I thank you very much. Senator Shelby. Senator SHELBY. Mr. Chairman, I’ll be brief. I ask that my written statement be made part of the record. Chairman INOUYE. Without—— 176

Senator SHELBY. And, Secretary—— Chairman INOUYE [continuing]. Objection. Senator SHELBY. Thank you. Secretary Mabus, General Conway, Admiral Roughead, we look forward to being with you this morning and hearing your testimony and also have a chance to question you on some very important issues. Thank you. Chairman INOUYE. Thank you. Senator KOHL. No statement. Chairman INOUYE. Then I’ll begin with the questioning, if I may. But, first, we’ll call upon the Secretary. SUMMARY STATEMENT OF HON. RAY MABUS Mr. MABUS. Mr. Chairman, Mr. Vice Chairman, members of the subcommittee, it’s a real pleasure to be here with you today. The CNO, the Commandant, and I are particularly grateful to the commitment that the members of this subcommittee have shown to our men and women in uniform in the Navy and the Marine Corps. We’re exceptionally proud to be representing the sailors, marines, civilians, and their families that are with the Department of the Navy. The Navy and the Marine Corps remain the most formidable expeditionary fighting force in the world, capable of global operations across the entire spectrum of warfare. Today, 40 percent of our forces are deployed and over one-half of our fleet is at sea. In Helmand Province, Afghanistan, more the 16,000 marines are engaged in major combat, counterinsurgency, and engagement operations. They’re supported there by naval aircraft flying close air support from Eisenhower and from our forward-deployed expeditionary aviation assets. A total of 12,000 sailors are on the ground in Iraq, Afghanistan, and across the greater Middle East, and another 9,000 sailors and marines are embarked on our ships at sea. Off the coast of Africa, our ships are protecting international commerce and operating as a partnership station with regional allies. Off the coast of South America, other ships are stemming the flow of illegal narcotics into the United States. Our ballistic missile defense forces are ready to defend against any threat to international peace in Europe, the Middle East, and the Pacific Rim. Our forward-deployed forces continue their role as a strategic buffer and deterrent against rogue regimes and potential competitors, alike. In Haiti, as the chairman mentioned, the Bataan and 1,000 marines from the 22d Marine Expeditionary Unit continue to provide humanitarian aid, medical assistance, and disaster relief. The Navy and Marine Corps are flexible, responsive, and everywhere our Nation’s interests are at stake. Our global presence reduces instability, deters aggression, and allows us to rapidly respond to any crisis that borders the sea. I believe that the President’s fiscal year 2011 budget for the De- partment of the Navy is a carefully considered request that gives us the resources we need to conduct effective operations and meet all the missions we have been assigned. 177 Our shipbuilding and aviation requests concur with the findings of the Quadrennial Defense Review (QDR) and its objective of prevailing in today’s wars, preventing conflict, preparing for future wars, and preserving the force. With this budget, the Navy and Marine Corps will continue to maintain the maritime superiority of our forces, sustain a strong American shipbuilding industrial base, and ensure our capacity for rapid global response. Across the Future Years Defense Program (FYDP), we’ve requested funds to build an average of 10 ships per year, including 1 carrier, 1 big deck amphibious ship, 10 Virginia-class submarines, and 17 littoral combat ships. We’ll leverage the technologies captured from canceled programs like the CG(X) and the truncated DDG 1000 program into what will become our Flight III Burke-class DDGs. These technologies include SPY-3 and the air and missile defense radar. Through the submitted shipbuilding plan, we will increase the size of our fleet to approximately 320 ships by 2024. In our shipbuilding program, I think we’ve made the most cost- effective decisions to achieve the most capable force, one that achieves equal flexibility to confront missions, across the spectrum of conflict, from the technologically complex, like ballistic missile defense and integrated air defense, to low-intensity humanitarian response and regional engagement. In aircraft procurement, we’ve requested just over 1,000 aircraft across the FYDP, including both fixed and rotary wing. Over the next year, the Navy and Marine Corps will continue to move ahead with changes to our acquisitions process. In compliance with the Weapons Systems Acquisitions Reform Act, we are aggressively developing our acquisition strategies to ensure that on-time and on-budget is the standard for Navy and Marine Corps programs. I’m grateful for the support of this subcommittee for the decision to recompete the LCS Program when it failed to meet program standards. I assure you that we will not hesitate to recompete or cancel other programs whenever substandard performance demands change. Change is also required to address the way in which the Navy and Marine Corps use and produce energy. Energy reform is an issue of national security, and it’s essential to maintaining our strategic advantage, warfighting readiness, and tactical edge. By 2020, I’ve committed the Navy to generate over one-half the energy we use from alternative sources. This is an ambitious goal, but one which can be met. Forty years ago, I stood watch on the deck of the U.S.S. Little Rock as a young junior officer. Today, I have the solemn privilege of standing watch on behalf of our Navy and Marine Corps in a time of war. I am honored by the trust the President and the Con- gress have placed in me, and fully recognize the solemn obligation I have to those who defend us. I, along with the CNO and the Commandant, look forward to hearing your thoughts and answering any questions you may have concerning this budget, any specific programs or policies. 178

PREPARED STATEMENT I also look forward to working with you as we move forward to sustain the Navy and Marine Corps as the most formidable expeditionary fighting force in the world. Thank you. Chairman INOUYE. Thank you very much, Mr. Secretary. [The statement follows:]

PREPARED STATEMENT OF HON. RAY MABUS Chairman Inouye and Senator Cochran, it is a pleasure to be here today with the House Armed Services Committee as the representative of the nearly 900,000 Sail- ors, Marines, and civilians that make up the Department of the Navy. The Chief of Naval Operations, the Commandant of the Marine Corps and I are privileged to lead some of the best men and women in the country, who are selflessly serving the United States all around the world in support of our safety, our security, and our national interests. The Navy and Marine Corps remain the most formidable expeditionary fighting force in the world. We are America’s ‘‘Away Team’’. The mission and experience of our team is well matched to the multiple and varied challenges that threaten our nation’s security and global stability. Today the Navy and Marine Corps are conducting operations across the spectrum of military operations, from major combat and ballistic missile defense to humanitarian assistance and disaster relief. Fifteen thousand Marines are at the forefront of our nation’s defense, serving in and around Helmand Province, Afghanistan. By spring this number will grow to almost 20,000. It is a testament to the responsiveness and combat capability of the Marine Corps that the first troops to depart for Afghanistan in the wake of the President’s December 1 announcement were 1,500 Marines from Camp Lejuene, North Carolina. The new arrivals, who deployed before the end of last year, joined the Second Marine Expeditionary Brigade already in place. Together they are taking the fight to the Taliban and al-Qaeda in their sector and assisting the Afghan Pro- vincial Government in reestablishing control. General Conway describes their capability as a ‘‘two-fisted fighter,’’ capable of simultaneously combating an adaptive and insidious insurgency among the Afghan civilians while maintaining the skill set to conduct major combat operations. The Navy in Afghanistan is contributing Special Operations Forces, Explosive Ordnance Disposal Teams, Seabee civil engineering assets, all of the airborne expeditionary tactical Electronic Warfare capability, medical and intelligence professionals, and logistical support. From our carriers operating in the Indian Ocean, we are launching a significant percentage of the close air support that watches over our Marines and Soldiers on the ground. The Navy has over 12,000 Sailors on the ground in Central Command supporting joint and coalition efforts in both Iraq and Afghanistan and another 9,000 Sailors at sea supporting combat operations. The Navy and Marine Corps today are globally engaged in a host of other security and stability operations. In our cruisers and destroyers, the Navy has built a strong ballistic missile defense force. These multi-mission ships routinely deploy to the Mediterranean, the Arabian Gulf, and the Western Pacific and extend an umbrella of deterrence. Across the Future Years’ Defense Program we will expand this mission and operationally implement the President’s decision in September 2009 to focus on sea-based ballistic missile defense. That capability is complemented by the continued preeminence of the ballistic missile submarines in our strategic deterrent force, who operate quietly and stealth- ily on station every day of the year. In the Gulf of Aden and Western Indian Ocean, Combined Task Force 151 is leading the international effort to combat piracy in the Gulf of Aden. They are coordinating their operations with forces from the European Union, NATO, and a total of 24 nations contributing ships, aircraft, and staff personnel as well as operational and intelligence support. Our ships and maritime patrol aircraft in the Caribbean and off South America are working with the Coast Guard-led Joint Interagency Task Force—South, which ties together information and forces from 13 nations to stem the flow of illegal narcotics into the United States. In 2009 alone they contributed to the seizure or disruption of almost 220,000 kilograms of cocaine with a street value of over $4 billion. Both the Navy and Marine Corps routinely conduct training exercises and multi- lateral operations with nations all around the world to solidify our relationships 179 with traditional allies and forge partnerships with new friends. Global Partnership Stations in Africa, South America, and the Pacific are training hundreds of Sailors, Marines, and Coast Guardsmen from dozens of nations and are supporting regional diplomatic and humanitarian engagement efforts, like those of the hospital ship USNS Comfort and the Fleet Auxiliary USNS Richard E. Byrd in the summer of 2009. The two ships together treated over 110,000 patients in the Caribbean, South America, and Oceania, and the USNS Comfort furthered an existing partnership with numerous civilian aid organizations. The Navy-Marine Corps team remains on the front-line of response to natural disasters. In 2009 we provided humanitarian assistance to Indonesia, the Philippines, and American Samoa, and delivered thousands of tons of food, water, and medical supplies to those affected by devastation. After the January 12 earthquake in Haiti, the Navy and Marine Corps responded immediately. Within a week of the earthquake, 11 Navy ships, including the carrier U.S.S. Carl Vinson, the big-deck amphibious ship U.S.S. Bataan, and the hospital ship USNS Comfort were on station off the coast of Haiti. These ships embarked 41 Navy and Marine Corps helicopters and approximately 2,000 Marines of the 22nd Marine Expeditionary Unit. On station, our units treated patients, provided helicopter lift capability, and delivered hundreds of tons of relief aid. Additional personnel and capabilities continued to flow in over the next weeks. Our mission there will continue as long as required. The Navy and Marine Corps are flexible, responsive, and everywhere that our nation’s interests are at stake. The Navy and Marine Corps’ global presence reduces instability, deters aggression, and allows for rapid response to a wide range of contingencies. In order to ensure our continued global mobility, the Department of the Navy strongly supports accession to the Law of the Sea Convention (UNCLOS). The United States must continue to take maximum advantage of the navigational rights contained in the Convention. Ratification would enhance stability for international maritime rules and ensure our access to critical air and sea lines of communication. I have now been the Secretary of the Navy for 9 months, and in that short period of time I have met thousands of our Sailors and Marines serving on the front lines at sea and ashore. I have been constantly inspired by the high morale, courage, and commitment to serving our country displayed by every one of them as they conduct our missions. In return, I have continually expressed to them the appreciation of the American people for the sacrifices they and their families are making every day. I have met our operational commanders and seen first-hand the warfighting readiness of our Fleet and our Marine Forces. I have inspected the facilities of our industry partners who are building the Navy and Marine Corps of tomorrow. With the advice and support of my leadership team, I have made some initial decisions to better prepare the Navy and Marine Corps for the challenges of the future. These ob- servations and our initial actions have given me a good picture of the Navy and Ma- rine Corps, and from this vantage I can report to Congress and the President the current state of the Services, the budgetary requirements we need to successfully perform our mission, and the future direction I believe we must take. The Department of the Navy’s fiscal year 2011 budget request reflects the Presi- dent’s priorities, Secretary Gates’ strategic and fiscal guidance, and fundamentally aligns with the 2010 Quadrennial Defense Review (QDR) priorities: Prevailing in today’s wars; preventing and deterring conflict; preparing for a wide range of future contingencies; and preserving and enhancing the All-Volunteer Force. This budget request of $160.7 billion will maintain across the Future Years’ De- fense Program our commitment to a strong industrial base. The fiscal year 2011 request of $18.5 billion for contingency operations includes incremental costs to sustain operations, manpower, equipment and infrastructure repair as well as equipment replacement to support our focus on increasing threats in Afghanistan and elsewhere. In the fiscal year 2011 budget request, we have included funds for 9 ships, including 2 additional Virginia class submarines, 2 destroyers in the restarted Arleigh Burke line, a lower-cost commercial variant of the Mobile Landing Platform, the multi-role Landing Helicopter Assault Replacement, a Joint High Speed Vessel and 2 Littoral Combat Ships, which will be constructed under the terms of the down- select we will conduct this fiscal year. In aviation, we have requested 206 aircraft in fiscal year 2011, including 20 F–35 Joint Strike Fighters for both the Navy and Marine Corps, 24 MH–60R and 7 P–8As to begin replacing our aging ASW and maritime patrol squadrons, 18 MH–60S for logistics support, 28 H–1 variant helicopters and 30 MV–22 for the Marine Corps, 22 F/A–18E/F and 12 F/A–18G to continue replacing the EA–6B. For Marine Corps ground operations, we have requested funding for an additional 564 LVSR and HMMWV tactical vehicles. The fiscal year 2011 budget request also contains development funding for the Navy Unmanned Combat 180

Aerial System and continues development of the Broad Area Maritime Surveillance UAV. And we have continued our support of the Naval Expeditionary Combat Com- mand, including funding for a fourth Riverine Squadron. The Department’s long-range shipbuilding and aviation intentions are designed to sustain our naval superiority and they achieve a balance of capability and affordability that both wins today’s wars even while preparing for the challenges of the future. There are four strategic, tactical, and personnel management imperatives I believe the Department of the Navy must also address to maintain preeminence as a fighting force and successfully address whatever comes in the future. These four areas reinforce the strategic framework of the QDR and address the areas of risk it identifies. They are: Taking care of our Sailors, Marines, Civilians, and their Families; treating energy in the Department of the Navy as an issue of national security; creating acquisitions excellence; and optimizing unmanned systems. They underpin the development of our fiscal year 2011 budget request, execute Presidential policy, and comply with and respond to Congressional direction.

TAKING CARE OF SAILORS, MARINES, CIVILIANS, AND THEIR FAMILIES Sailors and Marines are the fundamental source of our success. They are our most important asset, and they must always come first in our minds and in our actions. One of my most important responsibilities as Secretary is to ensure adequate compensation, medical care, and family support services are provided to our Sailors, Marines, civilians, and their families. The Navy and Marine Corps will continue to recruit and retain the same high quality individuals we brought into and kept in the service in 2009. We remain committed to providing a competitive pay and benefits package to aid recruiting. The package includes not only basic pay and housing allowances, but also provides incentives for critical specialties in healthcare, explosive ordnance disposal, and nuclear propulsion. Beyond compensation, we recognize that quality of life programs are crucial to retention and the military mission. We are providing expanded career opportunities, opportunities for life-long learning, and a continuum of care and family support. The Department continues to support a wide array of readiness programs, including deployment support services, morale and welfare services, and child and teen programs. Our innovative personnel management and human resource programs were in fact recognized by civilian experts as among the best in the country when, in Oc- tober 2009, the Navy was named by Workforce Management Magazine as the winner of the Optimas Award for General Excellence. Since the attacks of September 11, 2001, over 10,000 Marines and Sailors have been wounded in action. Their service has been exemplary and unselfish, and in their sacrifice they have given so much of themselves for our country. The Depart- ment of the Navy, through the Wounded Warrior Regiment and the Navy Safe Har- bor Program, provides support and assistance to our wounded, ill, and injured service members and their families throughout recovery, rehabilitation, and reintegration. And we continue to provide encouragement and support for wounded Sailors and Marines, in partnership with the Department of Veterans Affairs, long after they have left the Service. Our medical community has continued to strive for excellence in the care of our Sailors and Marines. Navy Medicine has reached out to its civilian colleagues, and we have established partnerships with civilian hospitals to improve our understanding and care for those affected by traumatic brain injuries, mental health issues, amputation, and disfiguring injuries. I had the opportunity last fall to see this first-hand, when I witnessed groundbreaking pro-bono work in reconstructive surgery on behalf of Wounded Warriors at the UCLA Medical Center. We will continue to aggressively address the issues of sexual assault prevention and response. Sexual assault is a criminal act that is corrosive to the readiness and morale of a professional military organization. In the fiscal year 2011 budget request, we have requested funds to support a reinvigorated program under the supervision of a new Office of Sexual Assault Prevention and Response, which I created within the Secretariat to focus attention on the issue, develop effective training, and coordinate prevention and response programs across the Navy and Marine Corps. In 2010, the Department will move forward on expanding the opportunities for women in the Navy. We will establish a process to integrate women into the submarine force, beginning with nuclear-trained and Supply Corps officers on our ballistic and guided missile submarines. After 8 years of continuous combat operations, the Navy and Marine Corps’ people remain strong, and the CNO, CMC, and I are very focused on maintaining the over- 181 all health of the force. The fiscal year 2011 budget request reinforces these goals and is designed to provide the fiscal support necessary to sustain the force. The visible support of Congress to our personnel programs is deeply appreciated and has been vital in maintaining overall readiness.

ENERGY REFORM The way in which we use and produce energy is an issue of national security and is essential to maintaining our warfighting capabilities. At present, we simply rely too much on fossil fuels, which are susceptible to both price and supply shocks caused by events in volatile areas of the world largely outside the scope of our control. Those potential shocks have, in turn, strategic, operational, and tactical effects upon our forces. In addition, fossil fuel emissions are the root cause of many of the impending security challenges of tomorrow, and the QDR has correctly identified that climate change and its effects: rising sea levels, pressure on natural resources, and changes to the polar regions, will increasingly affect our force structure and the global security environment as the 21st century progresses. In order to improve our long-term strategic and fiscal position, I have set the Navy and Marine Corps on a path to change the way in which we use and produce energy. In October 2009, I issued five energy targets. They are ambitious in their scope, but I firmly believe that little will be accomplished without bold, innovative, and timely action. The most important of the targets commits the Navy and Marine Corps to generating half of all the energy we use, including that used by the operational fleet, from alternative sources by 2020. I have also committed the Navy and Marine Corps to consider energy as a mandatory evaluation factor in contracting, and to consider as an additional factor in our business dealings, the energy footprint of the companies that sell to the Navy and Marine Corps. America is a world leader precisely because of our willingness to not just embrace change, but to create it. The U.S. Navy has always been a technological leader. We moved from wind to coal in the 19th century, coal to oil early in the 20th century, and to nuclear power in mid-century. In every transition there were opponents to change, but in every case the strategic and tactical position of naval forces improved. In this century, I have asked the Navy to lead again by pioneering technological change through use of alternative energy. But I want to reiterate that every action and program we undertake must and will have as an effect improved warfighting capability. And we will strive in every case to improve energy efficiency and reach cost-neutrality over the life of the program. Many of our initiatives are already doing this. We conducted a ground test of an F/A–18 Hornet jet engine this fall running on a biofuel blend and we intend to conduct an airborne test of the ‘‘Green Hornet’’ later this year. In late 2010, the Navy will also conduct tests of a more efficient F/A–18 engine, which will increase the aircraft’s range. Afloat, the U.S.S. Makin Island, the first ship constructed with a hybrid-electric drive that dramatically lowers fuel consumption at lower speeds, saved approximately $2 million in a single transit to her new homeport in San Diego. Over the life of the ship, we estimate the savings will be up to $250 million using today’s fuel prices. Writ large across the Navy, as we begin to retrofit our DDG fleet with similar propulsion systems, the potential fuel savings will only grow. In addition to these tactical applications, we have implemented a number of energy projects at our facilities ashore, and numerous other efficiency initiatives throughout the Fleet. As the President clearly stated in Copenhagen, changing the way we use and produce energy is a national security imperative.

ACQUISITION EXCELLENCE The ships and aircraft of the Navy and Marine Corps are unmatched at sea and over land. Our precision munitions, networked targeting systems, armored vehicles, stealth technology, and unmanned vehicles are advanced systems that define the leading edge of warfare in all domains. These truths have been brought home to me during my visits with the defense industry. I have had the opportunity to visit shipyards, aircraft manufacturers, fac- tories, and depots; and I applaud the hard work and dedication of this country’s skilled workforce—Americans who take as much pride in their patriotism as they do in their craftsmanship. The issue before us all, however, is affordability. Acquisition costs are rising faster than our budget’s top-line, and without deliberate, sustained action to reverse this trend, we put the size and capability of the future force at risk. In accordance with the Weapons System Acquisition Reform Act passed by Congress in 2009, the Navy and Marine Corps will aggressively pursue additional ways to make the acquisitions process more rigorous; we will prudently safeguard the resources entrusted to us by 182 the American taxpayer, and we will fully meet the obligation we hold to our Sailors and Marines. This requires close examination of the way we do business in our policies, practices, priorities, and organization, with a clear focus on controlling cost. The Navy and Marine Corps will continue initiatives to raise standards, to improve processes, to instill discipline in procurement, and to strengthen the professional corps that manages our major defense acquisition programs. We are pressing forward with key initiatives that promise to improve our ability to affordably deliver combat capability to the fleet. We are improving the quality of our cost estimates, which underpin our investment decisions. We are strengthening our cost estimating group, requiring independent cost estimates, and incorporating Departmental best practices in the formulation of our Service Cost Position for all major programs. We are using these realistic cost and schedule estimates to drive difficult decisions at the front end of the requirements process. We are developing our acquisition strategies with the intent of expanding the use of fixed price contracts, leveraging competition, and tightening up on the use of incentive and award fees to ensure quality systems are delivered consistently on budget and on time to our Sailors and Marines. When we could not achieve these objectives this past year on the Littoral Combat Ship program, we rewrote the program’s acquisition strategy to improve performance through competition. I thank the Com- mittee for its strong support of this revised strategy, and I assure you that I will not hesitate to re-compete or cancel programs when sub-standard performance demands change. We are demanding strict discipline in the execution of our contracts. Before com- mencing production on new start ship programs, I have reported to you the results of reviews conducted to ensure that designs are mature. We are specifically clamp- ing down on contract changes, the most-often cited reason for cost growth, through improved policies and increased oversight. Our goals for modernizing today’s force and recapitalizing the fleet affordably cannot be accomplished without a healthy industrial base and strong performance by our industry partners. We have worked hard to procure our ships, aircraft, and weapon systems at a rate intended to bring stability to the industrial base and enable efficient production. The Navy’s long-range shipbuilding plan was developed with particular regard for maintaining the unique characteristics and strength of the base and our efforts support the QDR’s emphasis on maintaining the defense industrial base with appropriate levels of competition, innovation, and capacity. The Future Years’ Defense Program outlines construction of a balanced force of 50 ships, an average of 10 ships per year, which requires the full breadth of capabilities and services provided by our major shipbuilders and vendors. In the end, industry must perform. We will work with our shipyards, aircraft manufacturers, and weapon systems providers to benchmark performance, to identify where improvements are necessary, to provide the proper incentives for capital investments where warranted, and to reward strong performance with terms and conditions that reflect our desire for a strong government-industry partnership. To meet our objectives, we must be smart buyers. The acquisition workforce has been downsized over the past 15 years and in truth our professional acquisition corps has been stretched too thin. Accordingly, and with your strong support, we are rebuilding the acquisition workforce through a number of parallel efforts. We must both increase the number of acquisition workers and restore to the government the core competencies inherent to their profession. The Department has added 800 acquisition professionals in the last year towards the goal of increasing the community by 5,000 over the Future Years’ Defense Program. This represents a 12 percent growth in our workforce.

UNMANNED SYSTEMS The complex nature of today’s security environment, as well as current and future anti-access threats faced by the United States require that the Navy and Marine Corps investigate the contributions unmanned systems can make to warfighting capability. Unmanned systems are unobtrusive, versatile, persistent, and they reduce the exposure of our Sailors and Marines to unnecessary threats. They perform a vast array of tasks such as intelligence collection, precision target designation, oceanographic reconnaissance, and mine detection, and that array will grow expo- nentially year to year. Navy and Marine Corps unmanned systems have already made key contributions to operations in Afghanistan, Iraq, and in the counter-piracy effort off the coast of Africa. Unmanned aircraft systems have flown thousands of flight hours in support 183 of Operation Iraqi Freedom and Operation Enduring Freedom. Unmanned ground vehicles employed by the Marine Corps have conducted thousands of missions detecting and/or neutralizing improvised explosive devices. And unmanned maritime systems have provided improved port security. We continue to support research and development activities to improve these capabilities and increase the level of autonomy in unmanned systems. Over the Fu- ture Years’ Defense Program we will continue to focus on transitioning from research and development and limited deployments, through test and evaluation, to full fleet integration and operations. In order to best direct our research and harness the capabilities of unmanned systems, I am tasking the Department to develop a comprehensive roadmap for unmanned system development, to include a coordinated strategy for air, ground, surface, and subsurface systems focused on integration and interoperability with our existing platforms and capabilities. The initiatives and investments contained in the fiscal year 2011 budget request will move us onto this path. I look forward to reporting continued progress throughout the year.

CLOSING In this statement, I have discussed the strategic and tactical imperatives that guide the Department and influence the future decisions we will make. Specific programmatic requests are reflected in the fiscal year 2011 budget request, which I believe incorporates the difficult trade-offs and disciplined decisionmaking that you and the American taxpayer expect of us. We have carefully weighed risks and made proposals to you that will ensure we retain a ready and agile force capable of conducting the full range of military operations. And we will continue to work hard to be effective stewards of the resources you allocate to us. Forty years ago I stood watch on the deck of the U.S.S. Little Rock as a young junior officer. Today I have the solemn privilege of standing watch on behalf of our Navy and Marine Corps in a time of war and national challenge. I am honored by the trust the President and Congress have placed in me and I fully recognize the solemn obligation I have to those who defend us. That obligation fueled my desire to observe our people up close in their varied and often dangerous jobs. I’ve seen first hand the courage of our young Marines in Helmand, the determination of a wounded SEAL to walk despite losing two legs, the pride of a young Sailor in a hot engine room, the selfless dedication of corpsmen, nurses and doctors caring for the fallen. Sacrifice and service created and preserve the freedom and opportunity that we enjoy as Americans. Although we aspire to create a world in which violence and aggression have been eliminated, we understand that peace and stability are often secured only when strong nations and good people are willing and prepared to use decisive force against those who threaten it. The Navy and Marine Corps stand ready to do so. Your commitment to the service of our country and your recognition of the sacrifice of our Sailors, Marines, civilians and their families has been steadfast and is fully reflected in the support of this Committee for our key programs and our people. I, along with my partners, the Chief of Naval Operations, Admiral Roughead, and the Commandant of the Marine Corps, General Conway, look forward to hearing your thoughts and answering any questions you may have about our budget request or specific programs of interest. I also look forward to working closely with Congress as we move forward to sustain the Navy and Marine Corps as the most formidable expeditionary fighting force in the world. Thank you and Godspeed. Chairman INOUYE. And now, may I call upon the Chief of Naval Operations, Admiral Roughead?

STATEMENT OF ADMIRAL GARY ROUGHEAD, CHIEF OF NAVAL OPER- ATIONS Admiral ROUGHEAD. Chairman Inouye, Senator Cochran, and members of the subcommittee, it’s my honor to appear before you again today, representing more than 600,000 sailors and Navy civilians and our families. Sixty-five thousand of them are deployed, 12,000 on land in the Central Command area of operations, and 55 percent of our fleet is underway, carrying out our maritime strat- 184 egy, a prescient precursor to the 2010 Quadrennial Defense Re- view. They are projecting power into Afghanistan, building partnerships in Africa, delivering relief in Haiti, and providing ballistic missile defense in the Arabian Gulf and the eastern Mediterra- nean, with pride and determination. They’re even deployed in the first littoral combat ship, 2 years ahead of schedule. And in the first weeks of that ship’s deployment, they’ve already seized approximately 4 tons of cocaine with a street value of $89 million. It is our sailors and Navy civilians who make all things possible; and thanks to your support, we’ve made important progress in building tomorrow’s Navy, remaining ready to fight today, and supporting our sailors, Navy civilians, and families this year. This year’s budget submission will take us even further. As the high demand for our Navy continues apace, we have stabilized end strength, and the tone of the force remains positive. We will continue to aggressively improve wellness programs and medical and social services for our wounded warriors; indeed, all who serve. Our fleet, unlike other services, is a continuously deployed force that we reset in stride. Conducting routine, indeed regular, maintenance and training is how our ships and aircraft reach their expected service lives. We increased our base budget and overseas contingency operation, or OCO, funding requests for operation and maintenance in fiscal year 2011 over our levels of last year. Our operation and maintenance requests are focused tightly on meeting increased OPTEMPO requirements, sustaining ships and aircraft to reach expected service lives, sustaining flying-hour readiness requirements, and funding price increases. I strongly request your support for full funding of our operation and maintenance accounts. While we reset, we must also procure ships and aircraft to reach our requirement of more the 313 ships. Last year, we commissioned 9 ships, and over the next decade our plan procures an average of 10 ships per year; significant growth for the near term. For aviation, I remain committed to bringing new capabilities online—the Joint Strike Fighter and unmanned aircraft—and to maintaining the readiness of our current Naval Air Force, all of which give our Nation flexibility and response unencumbered by overseas basing. Affordability for all our plans will remain fundamental to our decisions. The effectiveness of our unmanned systems, ships, and aircraft is a feature of the systems which connect them. Last year, I brought information capabilities and resources under a single information dominance directorate within the Navy staff, and commissioned Fleet Cyber Command/10th Fleet. I see the benefits of this already. I’m proud of our Navy’s accomplishments last year, and I’m confident we can achieve even more with this year’s budget submission. Our risk continues to trend toward significant, and achieving the right balance within and across my priorities remains critical to mitigating it. But, I remain optimistic because of our outstanding sailors and Navy civilians and the spirit of our Nation. We have seen more challenging times, and have emerged pros- perous, secure, and free. 185

PREPARED STATEMENT I ask that you support our fiscal year 2011 budget request, and I thank you for all you do to make the United States Navy a global force for good, today and into the future. Thank you, sir. Chairman INOUYE. I thank you very much, Admiral Roughead. [The statement follows:]

PREPARED STATEMENT OF ADMIRAL GARY ROUGHEAD Chairman Inouye, Senator Cochran, and members of the Committee, it is my honor and pleasure to appear before you, once again, representing the more than 600,000 Sailors and civilians of the United States Navy. Every day, our dedicated Navy men and women are forward deployed protecting the global commons in every domain: sea, land, air, space, and cyberspace. I appreciate your continued support for them as our Navy protects our Nation and our national interests. When I signed our Maritime Strategy with General Conway and Admiral Allen more than 2 years ago, I was confident that the strategy would prepare us well for the current and future security environments. Since then, it has guided our operations and investments, and I am further convinced of its relevance to our operations today and of its enduring attributes. The 2010 Quadrennial Defense Review (QDR) validated the underlying principle articulated in the Maritime Strategy that preventing wars is as important as winning wars. The QDR also declared that U.S. security and prosperity are connected to that of the international system, that deterrence is a fundamental military function, and that partnerships are key to U.S. strategy and essential to the stability of global systems. These themes reinforce the tenets of our Maritime Strategy and the six core capabilities it identified for our maritime Services: forward presence, deterrence, sea control, power projection, maritime security, and humanitarian assistance and disaster response (HA/DR). My priorities for the Navy remain unchanged: to build tomorrow’s Navy, to remain ready to fight today, and to develop and support our Sailors, Navy civilians, and their families. We are making progress in these areas thanks to your continued support. Some highlights follow. We added nine new ships to our Fleet in 2009, including U.S.S. Freedom (LCS 1), currently on its first deployment, and U.S.S. Independence (LCS 2), our second Littoral Combat Ship. We delivered three DDG 51 destroyers and restarted the DDG 51 line to increase surface combatant capacity for maritime security, deterrence, and anti-submarine warfare. We are adapting our force to meet the Presi- dent’s demand for sea-based ballistic missile defense (BMD) of Europe while sustaining our current BMD missions in the Arabian Gulf and Western Pacific. Our Virginia class submarine program continues to excel with the delivery of U.S.S. New Mexico (SSN 779) 4 months ahead of schedule. We rolled out our first carrier variant of Joint Strike Fighter (F–35C) aircraft, the timely delivery of which remains essential to fulfilling our strike fighter requirements. We are conducting the first deployment of our Vertical Take Off and Landing Unmanned Aerial Vehicle (VTUAV) and we expect the first test flight of our Navy Unmanned Combat Aerial System demonstrator this year. In the information and cyberspace domain, I established Fleet Cyber Command/ U.S. Tenth Fleet as the global operator of Navy’s cyber, networks, cryptology/signals intelligence, information, electronic warfare, and space operations. I restructured the Navy staff to bring all Navy information capabilities and resources under our new Information Dominance Deputy Chief of Naval Operations and created the Navy Information Dominance Corps, integrating more than 45,000 Sailors and civilians from our existing intelligence, information professional, information warfare, meteorology/oceanography, and space communities. About 1,400 of these Sailors are deployed globally as individual augmentees (IAs) today, most supporting operations in the Central Command (CENTCOM) area of responsibility. More than 40 percent of our Fleet is underway daily, globally present and persistently engaged. Our forward presence enabled the rapid response of our aircraft carrier U.S.S. Carl Vinson and numerous other surface and USNS ships, helicopters, and personnel to Haiti to provide humanitarian aid after the devastating earthquake in January. We remain engaged in operations in Afghanistan and in the drawdown of U.S. forces in Iraq. Navy has more than 21,000 active and reserve Sailors on the ground and at sea in CENTCOM. This includes a doubling of our construction battalion (SEABEE) presence in Afghanistan and ongoing IA support to both operations. I recently issued our Navy Vision for Confronting Irregular Chal- 186 lenges to shape how our Navy will plan for, resource, and deliver a wide range of capabilities to confront irregular challenges associated with regional instability, insurgency, crime, and violent extremism at sea, in the littorals, and on shore. Our Navy continues to support our people and their families. We are in the process of expanding opportunities for service at sea to women in the Navy by opening to them assignments on submarines for the first time in history. Our Navy has received 19 national awards in the past 18 months for its workforce planning, life- work integration, diversity, and training initiatives. Most notably, Workforce Man- agement magazine awarded Navy the 2009 Optimas Award for General Excellence, which recognized the U.S. Navy as an employer of choice among the ranks of previous distinguished recipients such as Google, Intel, and Hewlett-Packard. We have met or exceeded overall officer and enlisted (active and reserve) recruiting goals for 2009 and we are on track to achieve similar success in 2010. I appreciate the support of Congress for our Fleet and its dedicated Sailors, Navy civilians, and their families that serve our nation every day. I continue to focus on ensuring our Navy is properly balanced to answer the call now and in the decades to come. Last year, I stated our risk was moderate trending toward significant because of the challenges associated with Fleet capacity, increasing operational requirements, and growing manpower, maintenance, and infrastructure costs. This risk has increased over the last year as trends in each of these areas have continued. We are able to meet the most critical Combatant Commander demands today, but I am increasingly concerned about our ability to meet any additional demands while sustaining the health of the force, conducting essential maintenance and modernization to ensure units reach full service life, and procuring our future Navy so we are prepared to meet the challenges of tomorrow. The costs to own and operate our Fleet continue to rise due to increasing operational demands, higher maintenance requirements, and growing manpower costs. Over the last decade, the overall size of our active Fleet decreased by more than 30 ships, about 10 percent, and our active duty end strength decreased by about 13 percent, while operational demands globally have grown. Our Navy’s high tempo of operations has placed additional stress on our smaller Fleet of Sailors, ships, and aircraft and we are consuming the service life of our Fleet at a higher than expected rate. We are implementing force management measures in the near term to stretch the capacity of our 286-ship force to meet increasing global requirements. Through our Fleet Response Plan, we are tailoring our training and maintenance cycles to generate ready forces, allowing us to meet the most critical Combatant Commander requirements today. The impact of these measures on our Fleet has been felt in longer deployments and shorter dwell times, which increase stress on our Sailors and drive up maintenance requirements and costs for our ships and aircraft. Reg- ular maintenance of our ships and aircraft, and training and certification of our crews between deployments, is essential to our ability to sustain our force. It is how we reset. This ‘‘reset in stride’’ is different from other Services. It ensures our ships and aircraft maintain the required continuous forward presence whether supporting coalition troops in Afghanistan, deterring North Korea and Iran, or providing humanitarian aid in Haiti. For our Navy, continuous reset translates into decades of service for each ship and aircraft, a significant return on investment. Our reset and readiness are tied directly to our operations and maintenance (O&M) funding. Over the last decade, we have relied upon a combination of base budget and overseas contingency operations (OCO) funding to operate and maintain our Navy. Our fiscal year 2011 OCO request for O&M is tightly focused on supporting our ongoing and increased operations in CENTCOM. Our fiscal year 2011 base budget request for O&M is focused on properly sustaining our ships and aircraft so they reach their expected service life; funding enduring readiness requirements, particularly in aviation; and funding price increases, most notably in fuel, to support our enduring operations. Together, our OCO and base budget O&M requests reflect our commitment to resource current operations while preserving our Fleet for future operations. I ask for your full support of this year’s O&M request. Our fiscal year 2011 budget request achieves the optimal balance among my priorities to build tomorrow’s Navy, to remain ready to fight today, and to develop and support our Sailors, Navy civilians, and their families. It supports our Maritime Strategy and the 2010 QDR and continues us on the path we started in fiscal year 2010 to support our forces forward, take care of our people, continue rebalancing our force to meet current and future challenges, and reform how and what we buy. Highlights follow. 187

BUILD TOMORROW’S NAVY Since the release of our Maritime Strategy, I have stated that our Navy requires a minimum of 313 ships to meet operational requirements globally. This minimum, a product of our 2005 force structure analysis, remains valid. We are adjusting our requirement to address increased operational demands and expanding requirements, as outlined in the QDR, for ballistic missile defense, intra-theater lift, and forces capable of confronting irregular challenges. Our shipbuilding plan addresses these operational needs by growing our Fleet to 315 ships in 2020 and peaking at 320 ships in 2024. Per the President’s direction, we will improve our capacity to conduct sea-based ballistic missile defense of Europe by increasing our inventory of Aegis- capable ships through our restarted DDG 51 production line and modernization of our existing cruisers and destroyers. The funding for these upgrades will deliver the capability and capacity of ships required to perform this mission while maintaining sustainable deployment ratios for our Sailors. To fulfill Combatant Commander requirements for intra-theater lift, we will increase the number of Joint High Speed Vessels (JHSV) in our Fleet; the large payload bays, speed, and shallow draft of these versatile ships make them capable of supporting a wide range of naval missions, including security cooperation, security force assistance, and logistics support. To provide forces capable of confronting irregular challenges, we will continue to pursue the planned number of Littoral Combat Ships, providing a flexible and modular ship optimized for operations close to shore. We are moving from developing a Maritime Prepositioning Force (Future) squadron optimized for high-end, forcible entry operations to augmenting our three existing Maritime Prepositioning Squad- rons (MPS) with enhanced sea basing capabilities that are useful across a wide range of military operations. The augmented MPS will support our amphibious warfare force, which we will build to a minimum of 33 ships to increase our capacity to conduct theater security cooperation, sustain combat and assistance operations from the sea, and hedge against future conflict. We have improved the balance among capability, capacity, affordability, and executabilty in our procurement plans by developing a shipbuilding plan that procures our most needed capabilities, increases Fleet capacity in the near-to-mid-term, and is fiscally executable within the FYDP. It carefully manages increasing levels of operational and institutional risk, recognizing that, for as much as our Navy does to protect our national security and prosperity, the overall economy of our nation undoubtedly does more. I am confident our near-term plan provides the capability and capacity we need to conduct contingency operations and build partner capacity while retaining our ability to deter aggressors, assure allies, and defeat adversaries. Beyond 2024, I am concerned about the decrease in Fleet capacity that will occur as our legacy cruisers, destroyers, submarines, and amphibious ships reach the end of their service lives. Many of these ships were brought into service during the 1980s, when we procured some ship classes at a rate of four to five ships per year. While economic and security conditions are sure to change between now and then, it takes 10 to 15 years to design and build our ships, which then remain in service for 20 to 50 years. A long view is necessary to ensure our Navy has sufficient capacity to protect America’s global national interests in the future. As directed by the QDR, we are working with the Air Force and Marine Corps on an Air Sea Battle concept that will identify the doctrine, procedures, training, organization, and equipment needed for our Navy to counter growing military threats to our freedom of action. This joint effort will help us inform investments and identify future opportunities to better integrate naval and air forces across the entire range of operations. We are already moving forward with the Air Force to streamline capabilities, manpower, and resources related to our unmanned aviation systems. We continue to pursue our unique maritime aviation capabilities in carrier- based strike, anti-submarine warfare, and naval special warfare missions. Underpinning the capacity and capability of our Fleet is a highly technical and specialized industrial base. A strategic national asset, our shipbuilding and aviation industrial base is essential to sustaining our global Fleet and remains a significant contributor to our nation’s economic prosperity. Our shipbuilding industrial base directly supports more than 97,000 uniquely-skilled American jobs and indirectly supports thousands more through second and third tier suppliers. The highly specialized skills in our shipbuilding base take years to develop and, if lost, cannot be easily or quickly replaced. Level loading and predictable ship procurement allow industry to stabilize its workforce and retain the critical skills essential to our national security. I am committed to reducing the total ownership cost of our Fleet so that what we buy today does not pressurize our ability to operate tomorrow. Significant cost drivers for our Fleet include increasing technical and design complexity, changes in 188 requirements, reductions in the number of ships procured, and higher labor costs. To reduce these costs, we are pursuing common hull forms and components, open architecture for hardware and software, and increased modularity. Moreover, we are considering total ownership costs in procurement decisions. We are exploring new ways to design our ships with greater affordability throughout their lives, including reducing costs of fuel consumption, maintenance, and manpower and by increasing the efficiency of our maintenance and support processes and organizations. We are leveraging open production lines to deliver proven and required capabilities, such as in our DDG 51 and EA–18G programs. We are promoting longer production runs with our Virginia class SSNs, EA–18G and F/A–18E/F, P–8A, BAMS, and DDG 51 programs. We are capitalizing on repeat builds to control requirements creep and increase predictability with our aircraft carrier, destroyer, and submarine programs. Finally, we are pursuing evolutionary instead of revolutionary designs to deliver required future capabilities. Our future missile defense capable ship, for example, will be developed by spiraling capability into our DDG 51 class ships, instead of designing and building a new cruiser from the keel up. I remain committed to delivering a balanced and capable Fleet that will meet our national security requirements. I seek your support for the following initiatives and programs:

AVIATION PROGRAMS Aircraft Carrier Force Structure The Navy remains firmly committed to maintaining a force of 11 carriers for the next three decades. With the commissioning of U.S.S. George H.W. Bush (CVN 77) and inactivation of the 48-year-old U.S.S. Kitty Hawk (CV 63), our last convention- ally powered aircraft carrier, we now have an all nuclear-powered carrier force. Our carriers enable our nation to respond rapidly, decisively, and globally to project power, as we have done in Iraq and Afghanistan, or to deliver humanitarian assistance, as we have done in Haiti, while operating from a small, yet persistent, footprint that does not impose unnecessary political or logistic burdens on other nations. Our carriers remain a great investment for our nation. Our eleven-carrier force structure is based on worldwide presence and surge requirements, while also taking into account training and maintenance needs. I thank Congress for granting us a waiver to temporarily reduce our force to ten carriers for the period between the inactivation of U.S.S. Enterprise (CVN 65) and the delivery of Gerald R. Ford (CVN 78). We will continue to meet operational commitments during this 33-month period by managing carefully carrier deployment and maintenance cycles. After the delivery of CVN 78, we will maintain an eleven-carrier force through the continued refueling program for Nimitz class ships and the delivery of our Ford class carriers at 5-year intervals starting in 2020. CVN 78 is the lead ship of our first new class of aircraft carriers in nearly 40 years. Ford class carriers will be our nation’s premier forward-deployed asset capable of responding to crises or delivering early decisive striking power in a major combat operation. These new carriers incorporate an innovative new flight deck design that provides greater operational flexibility, reduced manning requirements, and the ability to operate current and future naval aircraft from its deck. Among the new technologies being integrated in these ships is the Electromagnetic Aircraft Launch System (EMALS), which will enable the carrier’s increased sortie generation rate and lower total ownership costs. EMALS is on track for an aircraft demonstration later this year and is on schedule to support delivery of CVN 78 in September 2015. Strike Fighter Capacity: Joint Strike Fighter and F/A–18 E/F Our Navy remains committed to the Joint Strike Fighter (JSF) program. The timely delivery of the F–35C carrier variant remains critical to our future carrier airwing strike fighter capacity. Our Navy has the necessary tactical aircraft capacity in the near term to support our nation’s strategic demands; however, a January 2010 assessment forecasts a decrease in our carrier-based strike fighter capacity that peaks in 2018. We have a plan to address this capacity decrease that involves several management and investment measures. Our force management measures are targeted at preserving the service life of our existing legacy strike fighter aircraft (F/A–18A–D). We will reduce the number of aircraft available in our squadrons during non-deployed phases to the minimum required. We will reduce our Unit Deployed squadrons (UDP) from twelve aircraft to ten aircraft per squadron to match the corresponding decrease in Marine Corps expeditionary squadrons. We are accelerating the transition of five legacy F/A–18C squadrons to F/A–18 E/F Super Hornets using available F/A–18E/F aircraft and will 189 transition two additional legacy squadrons using Super Hornet attrition reserve aircraft. These measures make our legacy strike fighter aircraft available for High Flight Hour (HFH) inspections and our Service Life Extension Program, which together will extend their service life and manage to some extent the decrease in our carrier-based strike fighter capacity through 2018. These measures expend the service life of our Super Hornets earlier than programmed, so we are refining our depot level production processes to maximize throughput and return legacy strike fighter aircraft to the Fleet expeditiously. Our fiscal year 2011 budget procures 22 additional F/A–18E/F aircraft. Our investment measures are targeted at extending the service life of our F/A– 18A–D aircraft and procuring Joint Strike Fighter (JSF). HFH inspections, which have been in place for 2 years, provide the ability to extend the service life of our legacy F/A–18A–D aircraft to 8,600 flight hours, while engineering analysis is underway to determine the SLEP requirements necessary to reach the service life extension goal of 10,000 flight hours. The HFH and SLEP programs increase our institutional risk by diverting investment and maintenance funds from other accounts, but they are necessary measures to address our strike fighter decrease while preserving our investment in JSF. I remain committed to the JSF program because of the advanced sensor, precision strike, firepower, and stealth capabilities JSF will bring to our Fleet. While the overall system demonstration and development schedule for JSF has slipped, we still plan for our squadrons to receive their first JSF airplanes in 2014 and we have not reduced the total number of airplanes we plan to buy. We are monitoring the JSF program closely and managing our existing strike fighter capacity to meet power projection demands until JSF is delivered. Procurement of an alternate engine for JSF increases our risk in this program. The Navy does not have a requirement for an alternate engine, and its additional costs threaten our ability to fund currently planned aircraft procurement quantities, which would exacerbate our anticipated decrease in strike fighter capacity. Our fiscal year 2011 budget request procures seven F–35C aircraft. EA–18G Growler The proliferation of technology has allowed state and non-state actors to use the electromagnetic spectrum with increasing sophistication. Airborne Electronic Attack (AEA) provides one of the most flexible offensive capabilities available to the joint warfighter and it remains in high demand in traditional, irregular, and hybrid conflicts. The Navy continues to provide extensive AEA support from our carriers afloat and from our expeditionary EA–6B Prowler squadrons deployed currently to Iraq and Afghanistan. We are leveraging the mature and proven F/A–18E/F airframe production line to recapitalize our aging EA–6B aircraft with the EA–18G Growler. As directed in the QDR, we are planning to procure an additional 26 EA–18G Growler aircraft across the FYDP to increase joint force capacity to conduct expeditionary electronic attack. Our program of record will buy 114 total EA–18G aircraft, recapitalizing 10 Fleet EA–6B squadrons and four expeditionary squadrons. The program continues to deliver as scheduled. In September, our first EA–18G transition squadron, based at NAS Whidbey Island, reached Initial Operational Capability and it will deploy as an expeditionary squadron later this year. Our fiscal year 2011 budget requests funding for 12 EA–18Gs. P–3 Orion and P–8A Poseidon Multi-Mission Maritime Aircraft Your continued support of the P–3 and P–8A force remains essential and is appreciated greatly. Our P–3 Orion roadmap focuses on sustainment and selected modernization until it is replaced by the P–8A Poseidon. These aircraft provide capabilities ideally suited for regional and littoral crises and conflict, and are our pre-eminent airborne capability against submarine threats. Our P–3s are in high demand today for the time-critical intelligence, surveillance and reconnaissance they provide to the joint force on the ground in CENTCOM and for their direct contributions to our maritime domain awareness in key regions across the globe. P–3 Zone 5 wing fatigue has resulted in the unplanned grounding of 49 aircraft between 2007 and 2009, with more expected. Mitigation measures include a combination of targeted Zone 5 modifications and outer wing replacements. As of De- cember, we have returned 12 aircraft to service after completing Zone 5 modification and 32 aircraft are currently being repaired. As part of our sustainment program, we have included $39.6 million in our fiscal year 2011 budget request to conduct outer wing installations on nine of our P–3 aircraft. P–3 sustainment and modernization programs are critical to ensuring successful transition to the P–8A, while preserving essential maritime and overland battle space awareness. 190

The P–8A completed it’s first Navy test flight this past October and will resume integrated flight testing in March of this year. The P–8A will achieve initial operating capability and begin replacing our aging P–3 aircraft in 2013. Our fiscal year 2011 budget request procures seven P–8A aircraft. MH–60R/S Multi-Mission Helicopter The MH–60R and MH–60S successfully completed their first deployment together this past summer with the U.S.S. John C. Stennis carrier strike group. The MH– 60R multi-mission helicopter replaces the surface combatant-based SH–60B and carrier-based SH–60F with a newly manufactured airframe and enhanced mission systems. With these systems, the MH–60R provides focused surface warfare and anti- submarine warfare capabilities for our strike groups and individual ships. Our fiscal year 2011 budget request procures 24 MH–60R helicopters. The MH–60S supports surface warfare, combat logistics, vertical replenishment, search and rescue, air am- bulance, airborne mine counter-measures, and naval special warfare mission areas. Our fiscal year 2011 budget request procures 18 MH–60S helicopters.

SURFACE SHIP PROGRAMS Littoral Combat Ship (LCS) LCS is a fast, agile, networked surface combatant that is optimized to support naval and joint force operations in the littorals and capable of supporting open- ocean operations. It will operate with tailored-mission packages to counter quiet die- sel submarines, mines, and fast surface craft. The modular and open architecture design of the seaframe and mission modules provides the inherent flexibility to adapt or add capabilities beyond the current Anti-Submarine, Mine Counter- measures, and Surface Warfare missions. These ships will employ a combination of manned helicopters and unmanned aerial, surface, and undersea vehicles. U.S.S. Freedom (LCS 1) has completed her post-delivery testing, trial, and shakedown periods and commenced her maiden deployment in February to Southern Command and Pacific Command. Her deployment 2 years ahead of schedule will allow us to incorporate operational lessons more quickly and effectively as we integrate these ships into our Fleet. U.S.S. Independence (LCS 2) completed builder’s trials in October 2009 and acceptance trials in November 2009. We accepted delivery of Independence on December 18, 2009, and commissioned her January 16, 2010. In March 2009, fixed price contracts were awarded for U.S.S. Fort Worth (LCS 3) and U.S.S. Coronado (LCS 4) which are now under construction by Lockheed Martin and General Dynamics respectively. I am impressed and satisfied with the capabilities of both LCS designs and am committed to procuring 55 of these ships. Affordability remains the key factor in acquiring LCS in the quantities we require. After careful review of the fiscal year 2010 industry proposals, consideration of total program costs, and ongoing discussions with Congress, we made the decision to cancel for affordability reasons the Phase II requests for proposals for three fiscal year 2010 LCS ships and adjust our acquisition strategy. In fiscal year 2010, we will conduct a competition among the existing LCS industry participants to down-select to a single LCS design. The winner of the down-select will be awarded a block buy contract for up to 10 ships, to be procured from fiscal year 2010 through fiscal year 2014 at a rate of two ships per year, built in one shipyard. To sustain competition and increase capacity, the winner of the down-select will be required to deliver a Technical Data Package to the Navy to support competition for a second contract source. We plan to award up to five ships to a second source beginning in fiscal year 2012 with one ship and continuing with an additional two ships per year through fiscal year 2014. The winner of the down-select will provide combat systems equipment, up to 15 ship sets, for the ships built by the two contract sources: 10 sets for the 10 ships under contract with the winner of the down-select and up to five additional sets for the five ships being procured by the second contract source. The five additional sets will later be provided as government-furnished equipment to support the second source LCS contract. We intend to procure all future LCS ships within the fiscal year 2010 Na- tional Defense Authorization Act (NDAA) revised cost cap. Our down-select strategy leverages competition to the maximum extent practical, provides for economic procurement quantities, improves learning curve and commonality opportunities, and ultimately provides for program stability. We recently issued the requests for proposals for this contract and expect industry bids in March of this year. Consistent with our new strategy, our fiscal year 2011 budget requests two LCS seaframes and an additional $278 million to secure an LCS block buy, which is essential to lowering unit costs. I request your support as we acquire LCS in the most 191 cost-effective manner and deliver its innovative capability in sufficient capacity to our Fleet. Integrated Air and Missile Defense (IAMD) Integrated Air and Missile Defense (IAMD) incorporates all aspects of air defense against ballistic, anti-ship, and overland cruise missiles. IAMD is vital to the protection of our force, and it is an integral part of our core capability to deter aggression through conventional means. The demand for sea-based ballistic missile defense (BMD) is increasing significantly. The Navy’s mature and successfully demonstrated maritime BMD capability will play a primary role in the first phase of our nation’s plan to provide for the missile defense of Europe. Aegis BMD counters short, medium, and some intermediate range ballistic missiles through active defense and is able to pass target information to other BMD systems, thereby expanding the BMD battlespace and support of homeland defense. Currently, 20 ships (four cruisers and 16 destroyers) have this capability and are being used to perform maritime BMD. All of the Arleigh Burke class destroyers and nine of the Ticonderoga class cruisers are planned to receive BMD capability through our modernization program. DDG 51 Restart and Future Surface Combatant To address the rapid proliferation of ballistic and anti-ship missiles and deep- water submarine threats, as well as increase the capacity of our multipurpose surface ships, we restarted production of our DDG 51 Arleigh Burke class destroyers (Flight IIA series). These ships will be the first constructed with IAMD, providing much-needed Ballistic Missile Defense (BMD) capacity to the Fleet, and they will incorporate the hull, mechanical, and electrical alterations associated with our mature DDG modernization program. We will spiral DDG 51 production to incorporate future integrated air and missile defense capabilities. We are well underway with restarting DDG 51 production. We awarded advance procurement (AP) contracts for DDG 113 and 114, and expect to award an AP contract for DDG 115 in the coming months, to support the long lead items necessary for production of these ships. I thank Congress for supporting our fiscal year 2010 budget, which funded construction of DDG 113. We anticipate a contract award for DDG 113 production this Spring. Our fiscal year 2011 budget requests funding for the construction of DDG 114 and DDG 115 as part of our plan to build a total of eight DDG 51 ships through the FYDP. The Navy, in consultation with the Office of the Secretary of Defense, conducted a Radar/Hull Study for future surface combatants that analyzed the total ship system solution necessary to meet our IAMD requirements while balancing affordability and capacity in our surface Fleet. The study concluded that Navy should integrate the Air and Missile Defense Radar program S Band radar (AMDR–S), SPY– 3 (X Band radar), and Aegis Advanced Capability Build (ACB) combat system into a DDG 51 hull. While our Radar/Hull Study indicated that both DDG 51 and DDG 1000 were able to support our preferred radar systems, leveraging the DDG 51 hull was the most affordable option. Accordingly, our fiscal year 2011 budget cancels the next generation cruiser program due to projected high cost and risk in technology and design of this ship. I request your support as we invest in spiraling the capabilities of our DDG 51 class from our Flight IIA Arleigh Burke ships to Flight III ships, which will be our future IAMD-capable surface combatant. We will procure the first Flight III ship in fiscal year 2016. Modernization As threats evolve, we must modernize our existing ships with updated capabilities that sustain our combat effectiveness and enable our ships to reach their expected service life, which in the case of our destroyers and cruisers, is more than three decades. Our destroyer and cruiser modernization program includes advances in standard missiles, integrated air and missile defense, open architecture, and essential hull, mechanical and electrical (HM&E) upgrades. Maintaining the stability of the cruiser and destroyer modernization program is critical to achieving relevant future Navy capability and capacity. Our Navy plans to conduct DDG modernization in two 6-month availabilities. The first availability is focused on HM&E modifications, while the second availability, conducted 2 years later, is focused on combat systems modernization. The program will commence in fiscal year 2010 and focuses on the Flight I and II DDG 51 ships (hulls 51–78). All ships of the class will be modernized at midlife. Key tenets of the DDG modernization program include: an upgrade of the Aegis Weapons System to include an Open Architecture (OA) computing environment, an upgrade of the SPY radar signal processor, the addition of Ballistic Missile Defense capability, installation of the Evolved Sea Sparrow Missile (ESSM), an upgraded SQQ–89A(V)15 anti- submarine warfare system, integration with the SM–6 Missile, and improved air 192 dominance with processing upgrades and Naval Integrated Fire Control-Counter Air capability. The Cruiser Modernization Program will modernize all remaining cruisers (Base- line 2, 3, and 4). The first fully modernized cruiser, U.S.S. Bunker Hill (CG 52), was completed in June 2009. The key aspects of the CG modernization program include: an upgrade to the Aegis weapons system to include an OA computing environment, installation of an SPQ–9B radar, addition of the Evolved Sea Sparrow Missile (ESSM), an upgrade to Close In Weapon System (CIWS) Block 1B, an upgraded SQQ–89A(V)15 anti-submarine warfare system, and improved air dominance with processing upgrades and Naval Integrated Fire Control-Counter Air capability. Six Baseline 4 cruisers will receive the Ballistic Missile Defense upgrade. Our fiscal year 2011 budget requests funding for the modernization of three cruisers and three destroyers. DDG 1000 The DDG 1000 Zumwalt guided missile destroyer will be an optimally crewed, multi-mission surface combatant designed to fulfill long-range precision land attack requirements. In addition to providing offensive, distributed and precision fires in support of forces ashore, these ships will serve as test-beds for advanced technology, such as integrated power systems, dual band radars, and advanced survivability features, which can be incorporated into our other ship classes. The first DDG 1000 is under construction and approximately 20 percent complete. We recently notified Congress of a Nunn-McCurdy breach in this program as a result of our decision to reduce the number of DDG 1000s in the original program. DDG 1000 will be a three-ship class. It is scheduled to deliver in fiscal year 2013 with an initial operating capability in fiscal year 2015. Joint High Speed Vessel (JHSV) Intra-theater lift is key to enabling the United States to rapidly project, maneuver, and sustain military forces in distant, overseas operations. The Joint High Speed Vessel (JHSV) program is an Army and Navy joint program that will deliver a high-speed, shallow draft surface ship capable of rapid transport of medium payloads of cargo and personnel within a theater to austere ports without reliance on port infrastructure for load/offload. In addition, the Navy JHSV will be capable of supporting extensive Security Force Assistance and Theater Security Cooperation operations, including the hosting of small craft for training. A JHSV Production Readiness Review was completed in October 2009 and the first vessel construction began this past December with an anticipated delivery to the Army in fiscal year 2012. The second ship, a Navy vessel, is scheduled to be delivered in 2013. Our fiscal year 2011 budget includes funds for the construction of Navy’s third JHSV. Navy continues oversight of JHSV procurement for the five Army-funded vessels in this program. The Army assumes full responsibility for these five vessels following acquisition.

SUBMARINE PROGRAMS Virginia Class SSN The Virginia class submarine is a multi-mission submarine that dominates in the littorals and open oceans. Now in its 13th year of construction, the Virginia program is demonstrating that this critical undersea capability can be delivered affordably and on time. Thanks to Congress, these ships will begin construction at a rate of two a year in 2011, with two ship deliveries per year beginning in 2017. The Navy continues to realize a return from investments in the Virginia cost reduction program and construction process improvements through enhanced shipbuilder performance on each successive ship. These submarines are under budget and ahead of schedule, and their performance continues to exceed expectations with every ship delivered. Three of the five commissioned ships completed initial deployments prior to their Post Shakedown Availabilities, a first for the Navy. I am pleased with the accomplishments of the combined Navy-Industry team and look forward to even greater success as we ramp up production to two submarines next year. SSGN Our Navy has four guided missile submarines that provide high-volume strike and irregular warfare capabilities in support of operations and missions across the broad spectrum of conflict. SSGNs are performing well on deployment, and we are learning valuable lessons from each mission. Combatant Commanders value the long-range strike capability they provide and we are investigating options to sustain this capability in the most operationally and cost effective manner, to include options for expanding the long-range strike capacity of the submarine fleet. 193

SSBN and OHIO Replacement Our Navy supports the nation’s nuclear deterrence capability with a credible and survivable fleet of 14 Ohio class ballistic missile submarines (SSBN). Originally designed for a 30-year service life, this class will start retiring in 2027 after more than 42 years of service. The United States needs a reliable and survivable sea-based strategic deterrent for the foreseeable future. To ensure there is no gap in this critical capability, our fiscal year 2011 budget requests research and development funds for the Ohio Re- placement to support the start of construction of the first ship in fiscal year 2019. The Ohio Replacement will be a strategic, national asset with the endurance and stealth to enable our Navy to provide continuous, survivable strategic deterrence into the 2080s. Appropriate R&D investment is essential to design a reliable, survivable, and adaptable submarine capable of deterring all potential adversaries. We completed our Analysis of Alternatives study in 2009, and Milestone A is planned for April 2010. The Ohio replacement program will leverage the many successes of the Virginia SSN program to achieve acquisition and total ownership cost goals. The United States will realize significant program benefits as a result of our close partnership with the United Kingdom’s Vanguard SSBN replacement program, particularly in the design and construction of a common missile compartment. Our cooperation with the U.K. mitigates technical risk and shares design costs.

AMPHIBIOUS WARFARE SHIPS Our amphibious warfare ships provide essential capabilities for the full range of military operations, including theater security cooperation, humanitarian assistance, conventional deterrence, and forcible entry as part of major combat operations. With the unique capability to move hundreds of personnel and substantial material through complementary surface and air capabilities, these ships are key to our ability to overcome geographic, political, and infrastructure impediments to access. The Commandant of the Marine Corps and I have determined that a minimum of 33 amphibious assault ships represents the limit of acceptable risk in meeting the 38-ship requirement for supporting a forcible entry operation conducted by an assault echelon of two Marine Expeditionary Brigades (MEB). Our 33-ship force would be comprised of 11 LHA/D amphibious assault ships and a mix of 11 LPD 17 amphibious transport dock ships and 11 LSD dock landing ships. At this capacity, we are accepting risk in the speed of arrival of the combat support elements of the MEB. The QDR and our 30-Year Shipbuilding Plan account for 29–31 amphibious warfare ships within the FYDP. We plan to procure the 11th LPD 17 in 2012, which will allow us to realize a 33-ship minimum amphibious force in about fiscal year 2016. We continue to review options to achieve and sustain the minimum 33 amphibious ship assault echelon force. LPD 17 Class Amphibious Warfare Ship The LPD 17 class amphibious warfare ships represent the Navy and Marine Corps commitment to an expeditionary Fleet capable of power projection, security force assistance, and theater security cooperation in diverse operating environments. These ships have a 40-year expected service life and will replace four classes of older ships: the LKA, LST, LSD 36, and the LPD 4. Two LPD 17 class ships have completed their initial deployments, and U.S.S. New York (LPD 21), forged with steel from the World Trade Center, delivered in November 2009. We continue to apply the lessons learned during construction and initial operation of the early ships to those under construction. Quality is improving with each ship delivered as we continue to work closely with the shipbuilder to address cost, schedule, and performance concerns. LHA Replacement (LHA(R)) LHA(R) is the replacement for our aging Tarawa class ships, which will reach the end of their already extended service life between 2011–2015. LHA(R) will provide us flexible, multi-mission amphibious capabilities by leveraging the LHD 8 design and increasing aviation capacity to better accommodate the Joint Strike Fighter, MV–22, and other aircraft that comprise the future Marine Corps Air Combat Ele- ment. We laid the keel of the lead ship, U.S.S. America (LHA 6), in April 2009 and our fiscal year 2011 budget includes one LHA(R) which is split-funded in fiscal year 2011 and fiscal year 2012. Mobile Landing Platform (MLP) and Future Maritime Preposition Force (MPF(F)) The MPF(F) program was envisioned as a forward-deployed squadron of ships capable of at-sea assembly and rapid employment of forces in an area of interest during a crisis. Our requirement for amphibious and joint forcible entry operations was 194 reevaluated during the QDR and, as a result, we have adjusted our approach to augment our three existing Maritime Prepositioning Squadrons (MPS) instead of developing an MPF(F) squadron. MPF(F) was optimized for high-end, forcible entry operations, while the augmented MPS will provide enhanced sea basing capabilities across a wide range of contingency operations. Each existing MPS will be augmented by one Large Medium-Speed Roll-on/Roll-off (LMSR) cargo ship (transferred from the Army), a T–AKE combat logistics ship, and a new Mobile Landing Platform (MLP). The MLP will be based on existing designs for commercial ocean-going tankers and will meet most of the mission requirements envisioned for the original MLP design. The three augmented MPS reflect the QDR’s emphasis on day-to-day deterrence and partner capacity building, while continuing to meet forcible entry needs. Our fiscal year 2011 budget request procures one MLP.

INFORMATION DOMINANCE PROGRAMS Unmanned Aircraft Systems (UAS) We are investing in unmanned aircraft to meet an increasing warfighter demand for Intelligence, Surveillance and Reconnaissance (ISR), and we are making technology investments to expand UAS operations to other mission areas. The Broad Area Maritime Surveillance (BAMS) UAS will enhance our situational awareness and shorten the sensor-to-shooter kill chain by providing persistent, multiple-sensor capabilities to Fleet and Joint Commanders. The Vertical Take-off and Landing Tac- tical Unmanned Air Vehicle (VTUAV) Fire Scout is on its first deployment aboard the U.S.S. McInerney (FFG 8). We are developing a medium endurance maritime- based UAS and a Small Tactical Unmanned Aerial System (STUAS) that will support a variety of ships, Naval Special Warfare and Navy Expeditionary Combat Command units, and Marine Corps elements. The Navy Unmanned Combat Aircraft System demonstration (UCAS–D) is designed to prove carrier suitability of an autonomous, unmanned, low observable, carrier-based aircraft. This effort includes maturing technologies for aircraft carrier catapult launches and arrested landings, as well integration into carrier-controlled airspace. Initial flight tests to demonstrate carrier suitability are scheduled to start later this year and autonomous aerial refueling demonstrations are planned for 2013. We will leverage the lessons learned from operating the demonstrator in developing a low-observable unmanned carrier-launched airborne strike and surveillance system. Mobile User Objective System (MUOS) Our Maritime Strategy demands a flexible, interoperable, and secure global communications capability that can support the command and control requirements of highly mobile and distributed U.S. and coalition forces. Satellite communications give deployed forces a decisive military advantage and often offer the only communication means to support on-going operations. Rapidly expanding joint demand for more access at ever-higher data rates requires moving beyond our current legacy Ultra High Frequency (UHF) satellite capabilities. The Mobile User Objective Sys- tem (MUOS) will satisfy those demands when initial operational capability is reached in fiscal year 2012. I request your continued support of MUOS and the critical UHF satellite communication capability it will provide to the joint warfighter as the aging UHF Follow-On (UFO) constellation degrades. Next Generation Enterprise Network (NGEN) The Navy is continuing its transition from disparate independent computer networks to a single secure network environment. We are currently evolving our ashore network from the Navy Marine Corps Intranet (NMCI), the largest intranet in the world, to the Next Generation Enterprise Network (NGEN). NGEN Increment 1 is the follow-on to the existing NMCI contract, which expires at the end of fiscal year 2010. NGEN will sustain the services currently provided by NMCI, while increasing government command and control of our network and enabling secure, reliable, and adaptable global information exchange. Future NGEN increments will expand on services currently provided by NMCI and support seamless transition between afloat and ashore environments. A continuity of services contract is expected to be awarded this spring and NGEN Initial Operating Capability is scheduled for the summer of 2012. E–2D Advanced Hawkeye The E–2D Advanced Hawkeye aircraft, which replaces the E–2C, will improve nearly every facet of tactical air operations and add overland and littoral surveillance to support theater Integrated Air and Missile Defense against air threats in high clutter, complex electro-magnetic and jamming environments. The airborne 195 radar on the E–2D, with its improved surveillance capability, is a key pillar of the Navy Integrated Fire Control concept. The E–2D is scheduled to begin operational test and evaluation in 2012. The first Fleet squadron transition is planned for 2013, with deployment planned for October 2014. Our fiscal year 2011 budget requests four E–2D Hawkeye aircraft.

REMAIN READY TO FIGHT TODAY Our Navy continues to operate at a high tempo. We are filling new Combatant Commander requirements for ballistic missile defense, electronic attack, intelligence, surveillance, and reconnaissance (ISR), combat support, combat service support, and maritime security force assistance, in addition to conducting ongoing deployments in support of our maritime and national strategies. In CENTCOM alone, we have more than 9,000 Sailors at sea, including a U.S. Navy aircraft carrier and air wing dedicated to providing 24/7 air support to U.S. and coalition forces on the ground. Navy Riverine forces are on their sixth deployment to Iraq, conducting interdiction patrols and training their Iraqi counterparts. Our surface ships in the region are providing ballistic missile defense and conducting counter-terrorism, counter-piracy, maritime security, theater security cooperation, and security force assistance operations. On the ground in CENTCOM, we have more than 12,000 active and reserve Sailors supporting Navy, joint force, and coalition operations. Navy Commanders lead seven of the 13 U.S.-led Provincial Reconstruction Teams in Afghanistan. We have doubled our construction battalions (SEABEEs) in Afghanistan, increasing our capacity to build forward bases for U.S. forces and improve critical infrastructure in that country. Our Naval Special War- fare Teams continue to be engaged heavily in direct combat operations and our Ex- plosive Ordnance Disposal teams continue to conduct life-saving counter-Improvised Explosive Device operations on a daily basis. As we shift our effort from Iraq to Af- ghanistan, demand for Navy individual augmentees (IAs) has grown. We are providing IAs to support the increase of U.S. forces in Afghanistan while our IAs in Iraq remain at current levels to support the withdrawal of U.S. combat troops, maintain detention facilities and critical infrastructure, and assist coalition efforts until they can be turned over to Iraqi forces. During my recent trip to CENTCOM, I met with many of our dedicated Navy men and women supporting these efforts and I could not be more proud of their contributions. Their expert skill, ingenuity, competence, and drive are impressive and unmatched. Our high tempo will likely continue as combat forces draw down in Iraq and Af- ghanistan. Navy enabling forces will remain in CENTCOM to provide protection, ISR, and logistics support to our troops and partner forces in the region, while we will continue to maintain a forward-deployed presence of about 100 ships around the world to prevent conflict, increase interoperability with our allies, enhance the maritime security and capacity of our traditional and emerging partners, and respond to crises. Global demand for Navy forces remains high and continues to rise because of the unequalled and unique ability of our naval forces to overcome diplomatic, geographic, and military impediments to access while bringing the persistence, flexibility, and agility to conduct operations from the sea. Reset in stride is how our Navy prepares our Fleet to deploy again. Lifecycle maintenance and training between deployments is essential to our reset and to the ability of our ships and aircraft to reach their expected service lives. Although we are on pace to grow our Fleet for the next 10 years, our Fleet reduced in size over the past decade. As a result, while we continue to maintain the same number of ships at sea assigned to Combatant Commanders, we have a historically low number of ships available for at-sea training, exercises, and surge operations. Our fiscal year 2011 budget request balances the need to meet increasing operational requirements, sustain our Sailors’ proficiency, and conduct the maintenance required to ensure our ships and aircraft reach their full service lives. Highlights follow of initiatives that ensure our Navy remains ready to fight today. Depot Level Maintenance Our ships and aircraft are capital assets that operate in challenging physical and security environments. Keeping these assets in acceptable operating condition is vital to their ability to accomplish assigned missions and to reach their expected service lives. Timely depot level maintenance, performed in a cycle determined by an engineered assessment of expected material durability and scoped by actual physical condition, will preserve our existing force structure and ensure it can meet assigned tasking. Continued investment in depot level maintenance is essential to our efforts to achieve and sustain the force structure required to implement the Maritime Strategy. 196

Last year, I established the Surface Ship Life Cycle Management (SSLCM) Activ- ity to address deficiencies in our ship class maintenance plans that could prevent our ships from reaching their full service life. SSLCM has established an engineered approach to surface ship maintenance that optimizes existing maintenance availability work packages and better tracks ship material condition through robust inspections and corrosion control tasks. We accelerated our review of the requirements for certain ship classes, significantly improving the accuracy of our surface ship maintenance requirements in fiscal year 2011 over prior years. We are committed to a full review of all surface ship class maintenance plans, which will take several years. The value of investing in an engineered approach to maintenance is evident in our submarine force, where we have successfully extended the time between scheduled availabilities based on demonstrated material conditions and verification of engineering analysis. Because we have invested in this engineering and planning effort, we have been able to safely recover additional operational availability and reduce the overall depot level maintenance requirement for our submarines. This significant step has provided some of the resources needed to make additional investments in surface ship maintenance. Our combined fiscal year 2011 budget funds 99 percent of the projected depot ship maintenance requirements necessary to sustain our Navy’s global presence. Our budget funds aviation depot maintenance to provide 100 percent of the airframes for deployed squadrons and 96 percent of the non-deployed airframes. I request that you fully support our baseline and contingency funding requests for operations and maintenance to ensure the effectiveness of our force, safety of our Sailors, and longevity of our ships and aircraft. Shore Readiness Our shore infrastructure is a fundamental enabler of our operational and combat readiness and is essential to the quality of life and quality of work for our Sailors, Navy civilians, and their families. As I described last year, rising manpower costs and growing operational demands on our aging Fleet have led our Navy to take risk in shore readiness. This risk increases our maintenance, sustainment, restoration, and modernization requirements and continues our reliance on old and less efficient energy systems. These factors increase the cost of ownership of our shore infrastructure and outpace our efforts to reduce costs through facilities improvements and energy upgrades. At our current investment levels, our future shore readiness, particularly the recapitalization of our facilities infrastructure, is at risk. To manage our risk in shore infrastructure, our fiscal year 2011 budget request prioritizes funding for our most critical needs, including Navy and Joint mission readiness, nuclear weapons security and safety, and improving our bachelor quarters through sustained funding for our Homeport Ashore initiative. To guide investment in other areas ashore, we continue to pursue our capabilities-based Shore In- vestment Strategy, which targets our investment in shore infrastructure to where it will produce the highest return on investment and have the greatest impact on achieving our strategic and operational objectives, such as in areas that enable critical warfighting capabilities, improve quality of life, and fulfill Joint requirements. We have made essential progress and improvements in nuclear weapons security, child care facilities, and bachelor’s quarters. Thank you for funding all our requested military construction projects in 2010, as well as 19 additional projects and our Reserve program. Your support allowed us to address ship, aircraft, systems, infrastructure, and training requirements, while enhancing the quality of life and quality of service for our Sailors and their families. Your similar support and assistance through the American Recovery and Reinvestment Act of 2009 was also very helpful. As you requested, we identified Military Construction projects for Child De- velopment Centers and barracks and prioritized them according to operational need and the ability to obligate funds quickly. We selected infrastructure and energy projects based on mission requirements, quality of life impact, environmental planning status, and our ability to execute quickly. Our aggressive execution schedule is on track; we have awarded all but one of our 85 initial projects and construction outlays are ramping up swiftly. Training Readiness Our Fleet Synthetic Training (FST) program provides realistic operational training with seamless integration of geographically dispersed Navy, Joint, Interagency and Coalition forces. Using virtual and constructive training environments has allowed us to reduce our energy consumption and greenhouse gas emissions while providing the level of sophistication necessary to prepare our Sailors for operational and tactical mission proficiency. We continue to evolve FST to provide our Sailors with exposure to a multitude of warfare areas. Last year, we conducted our first 197

BMD Fleet Synthetic Training event, proving the viability and effectiveness of integrated Navy, Joint and partner-nation BMD training. The proliferation of advanced, stealthy, nuclear and non-nuclear submarines continues to challenge our Navy’s ability to guarantee the access and safety of joint forces. Effective Anti-Submarine Warfare (ASW) training with active sonar systems is vital to meeting potential threats. The Navy remains a world leader in marine mammal research and we will continue our robust investment in this research in fiscal year 2011 and beyond. Through such efforts, and in full consultation and cooperation with other Federal agencies, Navy has developed effective measures that protect marine mammals and the ocean environment from adverse impacts of mid- frequency active (MFA) sonar while not impeding vital Navy training. We continue to work closely with our interagency partners to further refine our protective measures as scientific knowledge evolves. It is vitally important that any such measures ensure the continued flexibility necessary to respond to future, potentially unforeseen national security requirements. Over the last year, we completed environmental planning for seven existing and proposed at-sea training and combat certification areas. We expect to complete planning for another six areas by the end of 2010 as we continue to balance our responsibility to prepare naval forces for deployment and combat operations with our responsibility to be good stewards of the marine environment. Conducting night and day field carrier landing practice (FCLP) prior to at-sea carrier qualifications is a critical training requirement for our fixed-wing carrier-based pilots, who must develop and maintain proficiency in the fundamentals necessary to conduct safe carrier-based flight operations. We continue to seek additional airfield capacity in the form of an outlying landing field (OLF) that will enhance our ability to support FCLP training for fixed-wing, carrier pilots operating from Naval Air Station Oceana and Naval Station Norfolk. The additional OLF will allow Navy to meet training requirements and overcome challenges related to capacity limits, urban encroachment, and impacts from adverse weather conditions at existing East Coast facilities. In August 2009, the Navy announced that the release of the draft environmental impact statement (EIS) for construction and operation of an OLF would be delayed. This delay was necessary to ensure Joint Strike Fighter noise analysis is included in the OLF draft EIS. The Navy is committed to developing, with local, state, and Federal leaders, a plan to ensure the OLF provides positive benefits to local communities while addressing Navy training shortfalls. Energy and Climate Energy reform is a strategic imperative. The Secretary of the Navy and I are committed to changing the way we do business to realize an energy-secure future. In alignment with the Secretary of the Navy’s five goals, our priorities are to advance energy security by improving combat capability, assuring mobility, ‘‘lightening the load’’, and greening our footprint. We will achieve these goals through energy efficiency improvements, consumption reduction initiatives, and adoption of alternative energy and fuels. Reducing our reliance on fossil fuels will improve our combat capability by increasing time on station, reducing time spent alongside replenishment ships, and producing more effective and powerful future weapons. Most of our projects remain in the demonstration phase; however, we are making good progress in the form of hybrid-electric drive, delivered last year on the U.S.S. Makin Island (LHD 8), bio-fuel engines, advanced hull and propeller coatings, solid state lighting, and policies that encourage Sailors to reduce their consumption through simple changes in behavior. Thanks to your support, the American Reinvestment and Recovery Act (ARRA) funded Navy energy conservation and renewable energy investment in 11 tactical and 42 shore-based projects totaling $455 million. Tactical projects included alternative fuel, drive, and power systems, while ashore projects included alternative energy (wind, solar and geothermal) investments in ten states and the installation of advance metering infrastructure in three regions. Our fiscal year 2011 budget continues to invest in tactical and ashore energy initiatives, requesting $128 million for these efforts. In our Maritime Strategy we addressed maritime operations in an era of climate change, especially in the ice diminished Arctic. In May 2009, I established the Navy’s Task Force on Climate Change (TFCC) to develop policy, investment, and force-structure recommendations regarding climate change in the Arctic and globally over the long-term. Our focus will be to ensure Navy readiness and capability in a changing global environment. 198

Second East Coast Carrier-capable Port Hampton Roads is the only nuclear carrier capable port on the East Coast. A catastrophic event in the Hampton Roads Area affecting port facilities, shipping channels, supporting maintenance or training infrastructure, or the surrounding community has the potential to severely limit East Coast Carrier operations, even if the ships themselves are not affected. Consistent with today’s dispersal of West Coast aircraft carriers between California and Washington State, the QDR direction to make Naval Station Mayport a nuclear carrier-capable homeport addresses the Navy’s requirement for a capable facility to maintain aircraft carriers in the event that a natural or manmade disaster makes the Hampton Roads area inaccessible. While there is an upfront cost to upgrade Naval Station Mayport to support our nuclear aircraft carriers, Mayport has been a carrier homeport since 1952 and is the most cost-effective means to achieve strategic dispersal on the East Coast. The national security benefits of this additional homeport far outweigh those costs. United Nations Convention on the Law of the Sea The Law of the Sea Convention codifies navigation and overflight rights and high seas freedoms that are essential for the global mobility of our armed forces. It directly supports our national security interests. Not being a party to this Convention constrains efforts to develop enduring maritime partnerships, inhibits efforts to expand the Proliferation Security Initiative, and elevates the level of risk for our Sail- ors as they undertake operations to preserve navigation rights and freedoms, particularly in areas such as the Strait of Hormuz and Arabian Gulf, and the East and South China Seas. By becoming a party to the Convention, the United States will be able to expand its sovereign rights to the increasingly accessible outer continental shelf areas of the resource rich environment of the Arctic, as well as in other locations where technological advances are opening up previously unobtainable resources. Accession to the Law of the Sea Convention remains a priority for our Navy.

DEVELOP AND SUPPORT OUR SAILORS, NAVY CIVILIANS AND THEIR FAMILIES Our Sailors, Navy civilians, and their families underpin our Maritime Strategy and are the foundation of our nation’s global force for good. We have great ships, aircraft, weapons, and systems, but it is our skilled and innovative Sailors who turn these ships, aircraft, and technologies into capabilities that can prevent conflict and win wars. In January 2010, we released the Navy Total Force Vision for the 21st century to guide our efforts to attract, recruit, develop, assign, and retain a highly- skilled workforce and reaffirm our commitment to supporting our uniformed and civilian people wherever they serve and live. We have transitioned from reducing end strength to stabilizing our force through a series of performance-based measures. Our stabilization efforts remain focused on maintaining a balanced force in terms of seniority, experience, and skills while supporting growth in high-demand areas such as cyber and special operations. We recognize the importance of retaining the talent and experience of our Sailors after they complete their active duty obligation so we are actively removing barriers associated with the transition between active and reserve careers to allow for a continuum of service over a lifetime. Our fiscal year 2011 budget requests authorization and funding for 328,700 active end strength and 65,500 reserve end strength. We continue to request OCO funding for our individual augmentees that are performing non-core Navy missions in support of contingency operations in Iraq and Afghani- stan. OCO funding remains critical to our ability to meet these missions without adversely impacting Fleet readiness or Sailor dwell time. We continue to provide support to our Sailors and their families, including those who are wounded, ill and injured, through expanded Fleet and Family Support services, Navy Safe Harbor, and our Operational Stress Control program. We are addressing aggressively the recent rise in suicide rates by implementing new training and outreach programs for Fleet commanders, Sailors, and Navy families to increase suicide awareness and prevention. We are focused on reducing sexual assaults in our Navy through our new Sexual Assault Prevention and Response Office and initiatives that emphasize our intolerance for sexual assault and related behavior in our Navy. We remain committed to helping our Sailors balance work and family commitments through initiatives such as 12-month operational deferments for new mothers (the most comprehensive policy of all military services), 21 days of administrative leave for adoptive parents, 10 days of paternity leave, a Career Intermission pilot program, and flexible work options. I continue to emphasize diversity outreach and mentorship to ensure we attract, leverage, and retain the diverse talent of our nation. Diversity among U.S. Naval Academy and Navy Reserve Officer Training 199

Corps (NROTC) applicants and graduates continues to grow each year. Through our Naval War College and Naval Postgraduate School, we are providing Joint Profes- sional Military Education and world-class higher education and training to our Sail- ors. We continue to build our Foreign Area Officer program to strengthen existing and emerging international partnerships. Our fiscal year 2011 budget request represents a balanced approach to supporting our Sailors and their families, sustaining the high tempo of current operations, and preserving Fleet and family readiness. I request the continued support of Congress for our fiscal year 2011 manpower and personnel initiatives. Recruiting and Retention Our Navy has attracted, recruited and retained a highly-skilled workforce over the past several years, and we expect this success to continue into fiscal year 2011. Fiscal year 2009 marked the second consecutive year Navy achieved its aggregate officer and enlisted recruiting goals in both the active and reserve components. At the forefront of this effort is our highly trained and professional recruiting force, which has postured us to respond to changing trends. We continue to attract the highest quality enlisted recruits in our history. We are exceeding DOD and Navy standards for the percentage of non-prior service enlisted recruits who have earned a high school diploma and whose test scores are in the upper mental group category. We met the Navy standard of 95 percent of recruits with a high school diploma in fiscal year 2009 and are currently at 96 percent this fiscal year. We exceeded the Navy standard of 70 percent of recruits in the upper mental group category in fiscal year 2009 (77 percent tested into this group) and we are currently at 78 percent this fiscal year. Navy will remain competitive in the employment market through the disciplined use of monetary and non-monetary incentives. Using a targeted approach, we will continue our recruiting and retention initiatives to attract and retain our best Sail- ors, especially those within high-demand, critical skill areas that remain insulated from economic conditions. Judicious use of special and incentive pays remains essential to recruiting and retaining these professionals in the current economic environment, and will increase in importance as the economic recovery continues. Our goal remains to maintain a balanced force, in which seniority, experience, and skills are matched to requirements. Diversity Our Navy draws its strength and innovation from the diversity of our nation. We continue to aggressively expand our diversity. We are committed to implementing policies and programs that foster a Navy Total Force composition that reflects America’s diversity. We have increased diverse accessions through targeted recruiting in diverse markets, developed relationships with key influencers in the top diverse metropolitan markets, and are aligning all Navy assets and related organizations to maximize our connection with educators, business leaders and government officials to increase our influencer base. Recruiting and retaining a diverse workforce, reflective of the nation’s demographics at all levels of the chain of command, is a strategic imperative, critical to mission accomplishment, and remains focus area for leaders throughout our Navy. We continue to expand our relationships with key influencers and science, technology, engineering, and mathematics (STEM)-based affinity groups to inform our nation’s youth about the unique opportunities available in our Navy. To increase our accessibility to diverse markets, we established NROTC units at Arizona State Uni- versity and Tuskegee University. Tuskegee University accepted students in the fall of 2009, and ASU will accept students in the fall of 2010. Our diversity outreach efforts have contributed to our 2013 U.S. Naval Academy and NROTC classes being the most diverse student bodies in our history. In the years ahead, we will continue to focus our efforts on retaining this talent by building and sustaining a continuum of mentorship approach that reaches out and engages Sailors throughout their career. This approaches includes social networking, strong relationships with affinity groups, and various programs offered by our Sailors’ immediate commands and associated leadership in addition to their respective enterprises and communities. Women on Submarines The Secretary of the Navy and I are in the process of changing the Navy policy that restricts women from serving aboard our submarines. This move will enable our Navy and, specifically, our submarine force to leverage the tremendous talent and potential of our female officers and enlisted personnel. Initial integration will include female officers assigned to ballistic missile (SSBN) and guided missile (SSGN) submarines, since officer accommodations on these submarines have more available space and appear to require less modification. The plan also integrates fe- 200 male supply corps officers onto SSBNs and SSGNs at the department head level. We are planning the first female submarine officer candidate accessions into the standard nuclear training and submarine training pipelines this year, making it possible to assign the first women to submarines as early as fiscal year 2012. Inte- gration of enlisted females on SSBNs and SSGNs and integration of officer and enlisted female personnel on attack submarines (SSNs) will occur later, once the extent of necessary modifications is determined. This initiative has my personal attention and I will continue to keep you informed as we integrate these highly motivated and capable officers into our submarine force. Sailor and Family Continuum of Care We remain committed to providing our Sailors and their families a comprehensive continuum of care that addresses all aspects of medical, physical, psychological, and family readiness. Our fiscal year 2011 budget request expands this network of services and caregivers to ensure that all Sailors and their families receive the highest quality healthcare available. Navy Safe Harbor, Navy’s Operational Stress Control Program, Reserve Psychological Health Outreach Program, Warrior Transition Pro- gram, and Returning Warrior Workshop are critical elements of this continuum. Navy Safe Harbor continues to provide non-medical support for all seriously wounded, ill, and injured Sailors, Coast Guardsmen, and their families through a network of Recovery Care Coordinators and non-medical Care Managers at 16 locations across the country. Over the past year, Safe Harbor’s enrollment has grown from 387 to 542. Over 84,000 Sailors have participated in Operational Stress Con- trol (OSC) training, which is providing a comprehensive approach designed to actively promote the psychological health of Sailors and their families throughout their careers while reducing the traditional stigma associated with seeking help. The Warrior Transition Program (WTP) and Returning Warrior Workshops (RWW) are essential to post-deployment reintegration efforts. WTP, established in Kuwait and expanded via Mobile Care Teams to Iraq and Afghanistan, provides a place and time for individual augmentees to decompress and transition from life in a war zone to resumption of life at home. The RWW identifies problems, encourages Sailors to share their experiences, refers family members to essential resources, and facilitates the demobilization process. Stress on the Force As we continue to operate at a high operational tempo to meet our nation’s demands in the Middle East and around the world, the tone of the force remains positive. We continue to monitor the health of the force by tracking statistics on personal and family-related indicators such as stress, financial well-being and command climate, as well as Sailor and family satisfaction with the Navy. Recent results indicate that Sailors and their families remain satisfied with command morale, the quality of leadership, education benefits, healthcare, and compensation. Suicide affects individuals, commands and families. We continue efforts at suicide prevention through a multi-faceted approach of communication, training, and command support designed to foster resilience and promote psychological health among Sailors. Navy’s calendar year 2009 suicide rate of 13.8 per 100,000 Sailors represents an increase from the previous year rate of 11.6 per 100,000 Sailors. Al- though this is below the national rate of 19.0 per 100,000 individuals for the same age and gender demographic, any loss of life as a result of suicide is unacceptable. We remain committed to creating an environment in which stress and other suicide- related factors are more openly recognized, discussed, and addressed. We continue to develop and enhance programs designed to mitigate suicide risk factors and improve the resilience of the force. These programs focus on substance abuse prevention, financial management, positive family relationships, physical readiness, and family support, with the goal of reducing individual stress. We continue to work towards a greater understanding of the issues surrounding suicide to ensure that our policies, training, interventions, and communication efforts are meeting their intended objectives. Sexual assault is incompatible with our Navy core values, high standards of professionalism, and personal discipline. We have reorganized our efforts in this critical area under the Navy Sexual Assault Prevention and Response (SAPR) program, which takes a multi-faceted approach to raise awareness of effective prevention methods, victim response and offender accountability. Recent program reviews undertaken by the Government Accountability Office, the Defense Task Force on Sex- ual Assault in the Military Services, and the Navy Inspector General will help us to identify program gaps and refine our program so we can continue to promote a culture that is intolerant of sexual assault. 201

Learning and Development Education and training are strategic investments that give us an asymmetric advantage over our adversaries. To develop the highly-skilled, combat-ready force necessary to meet the demands of the Maritime Strategy and the Joint Force, we have 15 learning centers around the country providing top-notch training to our Sailors and Navy civilians. We continue to leverage civilian credentialing programs to bolster the professional qualifications of Sailors in all ratings and increase Sailor equity in their own professional advancement. We are balancing existing education and training requirements with growth in important mission areas such as cyber warfare, missile defense, and anti-submarine warfare. Cultural, historical, and lin- guistic expertise remain essential to the Navy’s global mission, and our budget request supports expansion of the Language, Regional Expertise, and Culture (LREC) program for NROTC midshipmen, as well as implementation of the AF–PAK Hands Program. We recognize the importance of providing our people meaningful and relevant education, particularly Joint Professional Military Education (JPME), which develops leaders who are strategically-minded, capable of critical thinking, and adept in naval and joint warfare. Our resident courses at Naval War College, non- resident courses at Naval Postgraduate School and Fleet Seminar program, and distance offerings provide ample opportunity for achievement of this vital education. I appreciate the support of Congress in the recent post-9/11 GI Bill. We have led DOD in implementing this vital education benefit and continue to carefully balance our voluntary education investments to further develop our force.

CONCLUSION Our Sailors are performing brilliantly, providing incredible service in the maritime, land, air, space, and cyberspace domains around the world today. I am optimistic about our future and the global leadership opportunities that our Navy provides for our nation. Our fiscal year 2011 budget request continues the progress we started in fiscal year 2010 to increase Fleet capacity, maintain our warfighting readiness, and develop and enhance the Navy Total Force. I ask for your strong support of our fiscal year 2011 budget request and my identified priorities. Thank you for your unwavering commitment to our Sailors, Navy civilians, and their families, and for all you do to make our United States Navy an effective and enduring global force for good. Chairman INOUYE. Now, may I call upon the Commandant of the Marine Corps, General Conway.

STATEMENT OF GENERAL JAMES T. CONWAY, COMMANDANT, MARINE CORPS General CONWAY. Mr. Chairman, Senator Cochran, and distinguished members of the subcommittee, thank you for the opportunity to report to you on the posture of your Marine Corps. My pledge, as it has been over the years, is to provide you, today, with a candid and honest assessment. Having recently returned from a trip to theater, I’m pleased to report to you on the magnificent performance of marines and sailors in combat. If you count a 4-year enlistment as a generation of marines, we are now experiencing our third generation of great young patriots since our Nation was provoked on 9/11. The first generation broke trail, leading the strikes into Afghanistan and Iraq. The second generation quelled a once-volatile province of Anbar. Today, there are less than 130 marines in Iraq, but our third generation has more than 16,000 serving in Afghanistan. Your marines are fighting a skilled and determined enemy, but, with the Afghan Security Forces, they are once again proving that they are the strongest tribe in the Taliban stronghold of Helmand. Let me assure you from what the sergeant major and I witnessed firsthand, the highest morale in the Corps resides in those units posted in Afghanistan. 202 My written statement to the subcommittee provides a snapshot of the Corps and describes our near-term focus, long-term priorities, and our vision of the future. That vision matches closely the results of the Quadrennial Defense Review. The Secretary of De- fense seeks to create a U.S. Military more closely focused on hybrid threats, yet capable of responding to a major-level contingency. That combination essentially describes the Marine Corps that we have built today, a Corps we call a ‘‘two-fisted fighter,’’ able to perform equally well in a counterinsurgency or in a high-intensity combined-arms fight. Our resource expenditures, moreover, reflect our dual or swing capacity. That is to say that 100 percent of our Marine Corps equipment can be used in a hybrid conflict or in a major fight. Equipment procurement is, indeed, our primary concern, as we look at the fiscal year 2011 budget and beyond. Our requirements for equipment density in Afghanistan and our resolve to reestablish our maritime pre-positioned squadrons have driven equipment stocks to an all-time low in our operating forces at home station. The ability to properly train for deployment, and certainly the ability to respond to an unexpected contingency, is at significant risk, based on this increasing shortfall. Congress has promised us resources for reset and reconstitution. But, increasingly, we cannot wait for the guns to fall silent in Af- ghanistan for such an effort to begin. We ask for your help in this critical area. Our military construction accounts in the fiscal year 2011 budget and the FYDP are sufficient to help maintain a promise we have made to our marines, that they will have quality living spaces while they’re home between deployments. One need only visit some of our major bases and stations to realize that we waited too long to begin this effort. Similarly, we believe that, even in wartime, we must continue a heavy emphasis on education of our officers and our staff noncommissioned officers. A strong reservoir of strategic and operational thinkers is a must on sophisticated joint and combined battlefields. Therefore, a quality Marine Corps university with facilities to match our already world-class student body, faculty, and curriculum is a major priority. We trust we will receive your full support on our military construction investments that will repay huge dividends in the years to come. Ladies and gentlemen of the subcommittee, I must admit my own surprise that our Marine Corps and their families have remained so resilient over these 9 years of conflict. They have been incredibly determined, loyal, and courageous in an effort to see these two wars to a successful close. Much of the credit goes to you, in the Congress, for providing them with the finest, in terms of equipment, warrior care, quality of life for families, and compensation. The number one question in the minds of our troops is always, Is the country behind us? The Members of Congress have answered that question in spades, both by your apportionment of the Nation’s precious resources, but also through personal efforts to visit both troops in theater and our wounded at Bethesda and Walter Reed. As a result of all the above and the natural tendency of marines to stick around for a fight, our recruitment and retention are at all- 203 time highs. I predict that, for the second year in a row, we will close out reenlistment for both the first-term and career force halfway through the fiscal year. Clearly, such a phenomenon would not be possible if marines and their families were not happy in the service of their country. One day this long war with terrorists and Islamic extremists will be over. Your Marine Corps will cease being a second land army and will gladly rejoin our Navy brothers aboard amphibious ships in order to project America’s global presence, demonstrate Amer- ican goodwill, and, if need be, protect America’s vital interests. Until that day comes, however, your Corps will continue, as we say, ‘‘to do windows.’’ That is, we will continue to take aboard the indomitable youth of America and make them marines, with the absolute conviction that, as a result, they will one day be better citizens. We will be trained and equally as prepared to route Taliban fighters in Marjah as we are to feed beleaguered Haitians outside Port-au-Prince. With your continued support, and that of our loyal countrymen, we will do whatever the Nation asks us to do, and do it exceedingly well.

PREPARED STATEMENT Thank you, sir, and I look forward to your questions. Chairman INOUYE. I thank you very much, General. [The statement follows:]

PREPARED STATEMENT OF GENERAL JAMES T. CONWAY Chairman Inouye, Senator Cochran, Members of the Subcommittee, thank you for the opportunity to provide a written report for the record on the current posture of the Marine Corps. My pledge, as always, is to provide you with a candid and honest assessment. On behalf of all Marines, their families, and our civilian employees, I want to thank you for your concern and continued support. This brief statement contains a summary of our near-term focus and enduring priorities, an update on your Marine Corps today, a discussion of the challenges we see ahead, and our vision of the future. In addition to any testimony you wish to receive from me, I have directed the Deputy Commandants of the Marine Corps to meet with you as individuals and members of your respective subcommittees, and to provide you any other information you require. Our liaison officers will also deliver copies of 2010 U.S. Marine Corps Concepts and Programs to the offices of each member of the committee. This almanac and reference book contains detailed de- scriptions of all our major programs and initiatives. We hope you will find it useful.

YOUR MARINE CORPS We believe that Americans expect their Marines to be ready to respond when our country is threatened; to arrive on the scene on short notice anywhere in the world via the amphibious ships of the United States Navy, as was necessary when a disas- trous earthquake recently struck Haiti; and to fight and win our Nation’s battles. The public invests greatly in the Marine Corps. In turn, our commitment is to uphold their special trust and confidence and provide them the best return on their investment. Characteristics.—Your Marine Corps is a young force that provides great value to the Nation. —The average age of a Marine is 25 years old. —Almost half of the enlisted force—84,830 Marines—is between the ranks of private and lance corporal (pay grades E1–E3).1

1 As of December 23, 2009. 204

—Almost 70 percent of your Marines are on their first enlistment, and some 30,000 have been in uniform for less than 1 year.2 —The ratio of officers to enlisted Marines is 1:9—the lowest of all the services.3 —More than 136,000 Marines (67 percent) are in deploying units—what we call the Operating Forces. Nearly 30,000 Marines are forward deployed, forward based, or on training exercises around the world. —For 6.5 percent 4 of the baseline 2010 Defense budget, the Marine Corps provides: 17 percent of the Nation’s active ground combat maneuver units; 12 percent of the Nation’s fixed wing tactical aircraft; and 19 percent of the Nation’s attack helicopters. Expeditionary.—The Marine Corps is the Nation’s naval expeditionary, combined- arms force-in-readiness. To Marines, expeditionary connotes fast, austere, and lethal. —Expeditionary means rapid deployment by air or sea to respond to crises of temporary duration. For example, within 24 hours of the speech by the President of the United States in December announcing the current strategy in Afghani- stan, the lead elements of 1st Battalion, 6th Marines from Camp Lejeune, North Carolina were en route to Afghanistan. —Expeditionary means being efficient and effective while operating in an austere environment—a task-organized force that is manned and equipped no larger or heavier than necessary to accomplish the mission. —Expeditionary means being prepared for decisive action—to be lethal, if necessary—but also possessing the lesser-included capabilities for security cooperation, humanitarian assistance, or disaster relief. —In summary, the term expeditionary to Marines goes to the very heart of our service culture, core values, and warrior ethos. Service as part of an expeditionary force means embracing a Spartan way of life and regular deployments on foreign soil in furtherance of our Nation’s interests.5 Organization.—The Marine Corps is the only general-purpose force in the Depart- ment of Defense that is trained and equipped as the Nation’s first responders. —We organize in Marine Air-Ground Task Forces (MAGTFs). Under a single command element, the MAGTF integrates three major subordinate elements: (1) Ground Combat Element, (2) Aviation Combat Element, (3) Logistics Combat Element. Each element of the MAGTF is complementary, and Marine Corps forces are most effective and best employed as MAGTFs within the joint or multinational command structure. —MAGTFs are adaptive, general-purpose rapid response forces. They are multi- capable, transitioning seamlessly from fighting conventional and hybrid threats to promoting stability and mitigating conditions that lead to conflict. For example, in 2003, after completing a conventional, 350-mile attack over land from Kuwait to Baghdad, I Marine Expeditionary Force—a 60,000 Marine-plus MAGTF—was able to transition quickly to security and stability operations. Near-Term Focus.—We understand the economic challenges facing our country and the hard decisions Congress must make. We thank you for your unwavering support. This report discusses the near-term focus of the Marine Corps: —The current fight in Afghanistan and the responsible drawdown in Iraq. —Readiness and reset of equipment. —Modernization of the MAGTF. —Preparing for the next contingency and the uncertainties of the future. Enduring Priorities.—Through the future years defense plan and beyond, we are focused on: —Providing the Nation a naval expeditionary force fully prepared for employment as a MAGTF across the spectrum of operations. —Remaining the most ready when our Nation is least ready. —Providing for our Marines and their families.

2 As of December 1, 2009, the percentage of Marines on their first enlistment was 68.6 percent, and the number of Marines with less than 1 year on active duty is 29,032. 3 Authorized endstrength of 202,000 equals 21,000 officers plus 181,000 enlisted Marines equals 1:9. 4 6.5 percent of DOD budget represents fiscal year 2010 USMC Green dollars and Direct Blue (Navy) dollars. 5 This is consistent with the official Defense Department definition of an expeditionary force: ‘‘An armed force organized to accomplish a specific objective in a foreign country.’’ Joint Pub 1–02 Department of Defense Dictionary of Military and Associated Terms (Washington, D.C.: 2001, as amended through August 31, 2005), p. 193. 205

IRAQ AND AFGHANISTAN Operation Iraqi Freedom.—Since testimony before your committee last year, the Marine Corps has transferred authority for Anbar Province to the U.S. Army and is near completion of a responsible drawdown from Iraq. —From 2003–2009, our force levels in Iraq averaged 25,000 Marines. —As of February 19, 2010, there were 159 Marines in Iraq. By spring of this year, our mission in Iraq will be complete and your Marines will redeploy. Operation Enduring Freedom.—In Afghanistan, the mission has expanded. —As of September 23, 2009, there were more Marines in Afghanistan than in Iraq. —By March 2010, there will be more than 18,500 Marines in Afghanistan, and by mid-April, that number will grow to a robust MAGTF of 19,400 personnel with equipment, and will be commanded by a Marine two-star general. —Your Marines have already had success and have made a difference in some of the toughest regions of Afghanistan, primarily Helmand Province in the South—formerly a Taliban stronghold, and the source of the highest volume of opium production in the world. However, more work remains to be done. Summary Operations in Iraq and Afghanistan have required the Marine Corps to fight as a second land army. Although we have been successful in our assigned missions in Iraq and Afghanistan, that success has come at the price of degraded readiness for our designed missions. The Marine Corps will always do whatever the Nation requires. But, as Congress has authorized and resourced, the Marine Corps is trained, organized, and equipped for our primary mission as a force in readiness. The harsh environments and tempo of operations in Iraq and Afghanistan through 8 years of combat have accelerated wear and tear on our equipment. The enemy’s weapon of choice—the improvised explosive device or IED—has forced us to increase the weight of our personal protective equipment and the armor on our vehicles. The distributed nature of operations has shown us that our legacy tables of equipment were inadequate. The required type and number of ground vehicles, radios, and other major end items of equipment have significantly increased. In our infantry battalions, for example, the number of tactical vehicles has almost doubled while the number of radio sets has grown sevenfold. Our preliminary estimates indicate that the cost of restructuring the Marine Corps’ tables of equipment would be $5 billion over fiscal year 2012 through fiscal year 2015. The amount of equipment that has been damaged, destroyed, or has reached the end of service life from accelerated use has increased, and the cost associated with fixing or replacing this equipment has increased significantly. Based upon the Marine Corps current analysis, our estimated reset cost is $8 billion. The $8 billion consists of $3 billion requested in the fiscal year 2011 OCO and an additional long term reset liability of $5 billion upon termination of the conflict. Equipment on hand at home station to support training has been serious degraded. Particularly worrisome is our capacity to respond to other contingencies. We are institutionalizing the lessons learned in Iraq and Afghanistan in training, education, organization, doctrine, and capability development. One of the ways we are doing this is through the Marine Corps Center for Lessons Learned. The current operating environment in Iraq and Afghanistan has led to an expo- nentially increased need for intelligence collection assets down to lower levels of command. The Marine Corps Intelligence, Surveillance, and Reconnaissance Enter- prise (MCISR–E) provides support to the MAGTF in this operating environment by organizing all of the intelligence disciplines, sensors, and equipment and communication architecture into a single capability that is integrated and networked across all echelons.

READINESS Personnel Readiness Our people—the brave men and women who wear our uniform and the spouses, children, and the parents who support them—are our most valuable resource. In 2009, your Corps lost 65 Marines to enemy action in combat. We also lost 52 Ma- rines who died by suicide—this serious issue, which will be discussed later in this report, has my personal attention. Endstrength.—Current authorized endstrength is 202,100 Marines in the active component and 39,600 Marines in the Selected Reserve. —During fiscal year 2007, the Marine Corps requested and received authorization to grow 27,000 additional personnel by the end of fiscal year 2011. 206

—We completed our growth during fiscal year 2009—2 years ahead of schedule. We attribute this to four factors: quality recruiting, exceptional retention, reduced personnel attrition, and a great young generation of Americans who want to serve their country during wartime. —With this personnel increase, we will improve training, upgrade readiness, and enhance the quality of life for all personnel and their families. The goal is to build the equivalent capacity of three Marine Expeditionary Forces—the largest MAGTF and principal Marine Corps warfighting organization. —We are continuing to shape the Marine Corps with the right mix of units, grades, and occupational specialties. Quality Recruiting.—In fiscal year 2009, we exceeded goals in numbers and standards for the active component and the Selected Reserve. The active component accessed 31,413 personnel, and the Selected Reserve accessed 9,627 personnel. In fiscal year 2010, our goal is to access 27,500 enlisted personnel in the active component and commission 1,800 new officers. Enlistment Standards.—One of the Department of Defense standards for new recruits is that at least 90 percent will possess a high school diploma. The Marine Corps has chosen to maintain a higher standard; our goal is a high school graduation rate of 95 percent. In fiscal year 2009, for our combined active and reserve components, the high school graduation rate of our recruits exceeded 98 percent. First Term Reenlistments.—In fiscal year 2009, 8,011 first-term Marines reenlisted, meeting 109.2 percent of our goal. This represented a retention rate of 33.7 percent, exceeding our traditional retention rate of 24 percent. In the first quarter of fiscal year 2010, 5,194 first-term Marines have already reenlisted—77 percent of the goal for the entire year. Subsequent Term Reenlistments.—In fiscal year 2009, 7,985 Marines who had completed at least two enlistment contracts chose to reenlist again. This number represented 107 percent of our goal and a 78.6 retention rate—the highest in history. In the first quarter of fiscal year 2010, 5,685 Marines who had completed at least two enlistment contracts chose to reenlist again—82 percent of the goal for the entire year. Officers.—The quality of officers accessed and retained remains high. In one example, the share of Marine-option United States Naval Academy candidates in the top third of their graduating class greatly exceeded representative levels in 2008. The number of Naval Academy graduates who chose to become Marine Corps officers last year was 270—the highest number in history for the second year in a row. In fiscal year 2009, our officer retention rate was 93 percent and during fiscal year 2010, we expect officer retention to remain stable. Reservists.—The Marine Corps Reserve is a full partner in the total force. As of January 2010, there were 39,164 Marines in the Selected Reserve and another 55,233 in the Inactive Ready Reserve. Marine Forces Reserve includes 183 training centers in 48 states, the District of Columbia, and Puerto Rico. —The extensive contributions of the Reserve have reduced deployment requirements for the active component, thereby improving the health of the total force. More than 54,000 Marines from the Selected Reserve and the Inactive Ready Reserve have mobilized and deployed in support of Operations Iraqi Freedom, Enduring Freedom, or other operational commitments around the globe.6 ‘‘Every Marine into the Fight’’.—The majority of your Marines joined the Corps after our Nation was already at war. They expect to train, deploy, and fight because that is what they believe Marines are supposed to do. As such, the 2007 ‘‘Every Ma- rine into the Fight’’ initiative adjusted personnel assignment policies so Marines serving in non-deploying units or the supporting establishment would have the opportunity to deploy. At the same time, we monitor carefully the frequency and duration that units and individual personnel spend deployed. —To date, 73 percent of the available Marines have deployed in support of Oper- ations Iraqi Freedom and Enduring Freedom, or other operational commitments around the globe. —Individual Deployment Tempo.—We measure individual deployment tempo on a 2-year sliding scale—the number of days deployed out of the previous 730 days. In the last 7 years, we have seen a twentyfold increase in the individual deployment tempo of Marines in the active component. In October 2002, the number of Marines who deployed for at least 120 consecutive days in a 2-year period was 4,845. As of January 2010, 100,760 Marines had deployed for at least 120 consecutive days.

6 As of January 3, 2010. 207

—Unit Operational Tempo.—The metric we use to measure unit operational tempo is the ratio of ‘‘deployment to dwell’’—months deployed to months at home station. We limit the duration of deployments for units and individual Marines to no more than seven months for battalions and squadrons. Higher headquarters units deploy for 1 year. —Our goal is to achieve a 1:2 deployment to dwell ratio in the active component and a 1:5 ratio in the reserve component. Our reserve units are currently operating at a ratio that more closely approximates a ratio of 1:4, while many of our active component units, on average, are nearing the goal of 1:2 (see Table 1).

TABLE 1.—MAGTF UNIT DEPLOYMENT TO DWELL RATIOS 1

Average Ratio (Months De- MAGTF Element ployed:Months Home Station)

Command Element ...... 1:1.43 Ground Combat Element ...... 1:2.08 Aviation Combat Element ...... 1:2.11 Logistics Combat Element ...... 1:1.79 1 As of November 18, 2009. —The subordinate units most frequently deployed are Intelligence Battalions, 1:1.01 (Command Element); Infantry Battalions, 1:1.78 (Ground Combat Ele- ment); VMU Squadrons, 1:1.10, and Attack Helicopter Squadrons, 1:1.28 (Avia- tion Combat Element); and Explosive Ordnance Disposal Companies 1:1.30 (Lo- gistics Combat Element). Suicide Prevention.—The number of Marines who have died by suicide in recent years is shocking and unacceptable. This issue has my personal attention, and we have multiple programs at work to reverse this trend. —Causes.—Our studies have shown that regardless of duty station, deployment, or duty status, the primary stressors associated with Marine suicides are problems in romantic relationships, physical health, work-related issues, such as poor performance and job dissatisfaction, and pending legal or administrative action. Multiple stressors are typically present in a suicide. This is consistent with the findings of the other services and civilian agencies. —Deployments.—We analyze suicides monthly and annually for combat-related trends such as the number of deployments and dwell time. Although it is reasonable to assume that one or more deployments may cause an increase in suicides, to date, we have been unable to establish a direct correlation between deployments and suicides. Sexual Assault Prevention and Answer.—Sexual assault is a crime, and it tears at the very fabric of our ethos. We continue to train and educate all Marines on the warning signs and the situations that lead to sexual assault. To our commanders, we have reinforced their responsibility to investigate all allegations of sexual assault and take the appropriate actions consistent with their findings. Finally, we continue to take aggressive strides toward improving our Sexual Assault Preven- tion and Response Program. Civilian Employees.—Civilian employees are a vital part of the Marine Corps. In fiscal year 2010, civilian Federal employees will number more than 25,000. Through initiatives in management and career development, the Marine Corps is dedicated to maintaining a civilian workforce with the leadership skills and technical competencies necessary to meet the challenges of today as well as those of the future. —Traditionally, civilian employees have served primarily in the supporting establishment. Now, more than ever before, they are deploying with the operating forces and serving in positions traditionally occupied by active duty Marines. For example, we are in the process of hiring more than 260 tactical safety specialists, who will each rotate on deployments with the operating forces. We are also participating in DOD’s program to build a deployable Civilian Expedi- tionary Workforce. Families.—While we recruit Marines, we retain families. More than 45 percent of your Marines are married, and we believe that investing in military families is critical to the long-term health of the institution. When Marines know that their loved ones at home station have access to quality housing, healthcare, child development services, and education, they are better prepared to face the rigors of deployment and more inclined to stay in uniform when they return home. 208

—Family Readiness Programs.—Our baseline budget in fiscal years 2010 and 2011 for family programs is $399 million per year. We have reformed our family readiness programs at every level of command at all of our installations. As an example, we have created more than 400 full-time positions for family readiness officers down to the battalion and squadron level. —Child Care.—Today, we are currently meeting 64 percent of potential need for child care spaces. To meet the DOD standard of 80 percent of potential need based on the current population, we would require approximately 3,000 additional spaces. With your support, we have programmed an additional 2,615 spaces that will open over the next 18–24 months. —Families with Special Needs.—With an increase of $11 million for the Excep- tional Family Member Program in this year’s baseline budget, we have made great strides improving the programs that support special needs family members. Enrollment is now mandatory and more than 8,900 exceptional family members are in the program. The Marine Corps assigns a caseworker to each family, who assists during relocation, deployment, and life events. In addition, the Marine Corps now underwrites the cost of up to 40 hours of respite care per month for families in the program. To date, the Marine Corps has provided more than 250,000 hours of respite care. Wounded Warriors.—About 9,000 Marines have been injured or fallen seriously ill while serving in support of Operations Iraqi Freedom or Enduring Freedom. We are deeply committed to their care as well as the welfare of their families. Since activation in April 2007, the Wounded Warrior Regiment has provided a wide range of non-medical care for the injured and ill. The Marine Corps now also has wounded warrior battalions at Camp Pendleton and Camp Lejeune. —Infrastructure.—The Marine Corps is investing $50 million from the 2009 Over- seas Contingency Operations supplemental for the construction of resource and recovery centers at Camp Pendleton and Camp Lejeune. These recovery centers will provide spaces for counseling, physical therapy, employment support, financial management, and other training and outreach programs in support of our wounded. —Outreach.—With a 24-hour call center for wounded Marines and their families, the Wounded Warrior Regiment has contacted 99.4 percent of all Marines (7,654 out of 7,703) who were wounded since the beginning of Operations Iraqi Free- dom and Enduring Freedom, in order to determine their health status. We also maintain a toll-free number to the medical center in Landstuhl, Germany for families to contact their loved ones who have been wounded. —Recovery Care.—The Marine Corps has 42 recovery care coordinators, who coordinate non-medical services for Marines and their families during recovery, rehabilitation, and transition. Mental Health Traumatic Brain Injury.—Naval medicine remains at the forefront of researching and implementing pioneering techniques to treat traumatic brain injury. One tech- nique, Hyperbaric Oxygen Treatment, is showing great promise. We anticipate a study to begin this spring that tests the efficacy of this revolutionary treatment. The Marine Corps has a formal screening protocol for Marines who suffer concussions or who are exposed to blast events in theater. —Post-Traumatic Stress Disorder (PTSD).—We are attentive to the mental health of our warriors and we are dedicated to ensuring that all Marines and family members who bear the invisible wounds caused by stress receive the best help possible. We developed the Combat Operational Stress Control (COSC) program to prevent, identify, and holistically treat mental injuries caused by combat or other operations. —With the increased workload, we do have concerns about the capacity of mental healthcare in military medicine. Operational support and current treatment facility demands continue to stretch our mental health professional communities, even though DOD has taken many steps to increase mental health services. Our shortages of mental health professionals are a reflection of Nation-wide shortages of this specialty. We are actively engaged in discussions about possible solutions. Equipment Readiness We have sourced equipment globally, taking from non-deployed units and strategic programs to support our forces in theater. As a result, the amount of equipment remaining for non-deployed units to use for training and other potential contingencies is seriously deficient. 209

—For example, while the overall supply rating of Marine Corps units in Afghani- stan is near 100 percent, the supply rating of units at home station is less than 60 percent. —Additional equipment is being procured with supplemental funds, but the production rates are too slow to meet our requirements for new equipment orders. Equipment Reset.—As mentioned previously, the distributed and decentralized nature of operations in Iraq and Afghanistan has shown us that our legacy, 20th century tables of equipment are significantly inadequate. Moreover, the tempo of operations has accelerated the wear and tear on equipment. Also, the diversion of equipment in theater from Iraq to Afghanistan has delayed reset actions at our logistics depots in the United States. —Our preliminary estimates indicate that the cost of restructuring the Marine Corps’ tables of equipment would be $5 billion over fiscal year 2012 through fiscal year 2015. —In light of the continued high tempo of operations in Afghanistan, and the delay in reset actions due to the diversion of equipment in theater, we estimate the cost of reset for the Marine Corps to be $8 billion ($3 billion requested in the fiscal year 2011 OCO and an additional $5 billion reset liability upon termination of the conflict). Aviation Readiness.—All Marine Corps aircraft in support of overseas contingency operations are exceeding programmed rates, and are thus consuming service life at a rate sometimes three times higher than that scheduled for the lifetime of the aircraft. (See Table 2.) This will eventually result in compressed time lines between rework and, ultimately, earlier retirement of the aircraft than originally programmed. —It is critical that our aviation modernization programs, discussed in the next section of this report, continue to receive the support of Congress. —The majority of our legacy platforms are at the end of their service life and most of the production lines are closed.

TABLE 2.—FISCAL YEAR 2009 USMC AIRCRAFT UTILIZATION RATES—OVERSEAS CONTINGENCY OPERATIONS

Pro- grammed OCO Rates Aircraft Average Rates (Hours/ OCO Life Age (Years) (Hours/ Month) Usage Month)

AH–1W ...... 19 19.5 32.7 1.7x UH–1N ...... 35 21.7 30.0 1.4x CH–46E ...... 41 13.6 31.1 2.3x CH–53D ...... 40 23.8 50.3 2.1x CH–53E ...... 21 19.2 33.6 1.8x MV–22B ...... 3 20.9 29.4 1.4x AV–8B ...... 13 20.9 24.1 1.2x F/A–18A ...... 23 25.5 72.5 2.9x F/A–18C ...... 16 23.9 65.5 2.7x EA–6B ...... 27 26.4 66.0 2.5x Note: Programmed rates are defined in the Weapon System Planning Document and are based on the projected dates an aircraft will be replaced by a new platform or reworked to extend its service life. Programmed rates include monthly flight hours and the associated logistical support required for each aircraft. Strategic Prepositioning Programs Marine Corps prepositioning programs trace their origins back 30 years, when the Iranian revolution, the Soviet invasion of Afghanistan, the Iraqi attack on Iran, and the deepening civil war in Lebanon collectively brought to the forefront the limitations of strategic airlift to respond to no-notice contingencies. The solution—the Sec- retary of Defense testified in 1980, and Congress agreed—was prepositioned combat equipment, ammunition, and supplies afloat on commercial vessels underway or docked in strategic locations. The Marine Corps developed three squadrons of maritime prepositioned ships and, in 1982, began prepositioning equipment and ammunition underground in Norway. The first real test for these programs was in 1991, during Operation Desert Shield. In 2003, in Kuwait, the Marine Corps downloaded 11 vessels from all three prepositioned squadrons and moved 648 principal end items from Norway in preparation for Operation Iraqi Freedom. Without this capacity, the Marine Corps would not have been able to move half of the entire operating forces—more than 60,000 210 fully equipped Marines—halfway around the world for a 350-mile attack on Bagh- dad. When completely loaded, Marine Corps prepositioning vessels today carry more than 26,000 pieces of major equipment including tanks, wheeled tactical vehicles, and howitzers, as well as the necessary supplies to support the force. When measured against authorized allowances, the percentage of major item equipment (Class VII) currently present in the prepositioned fleet is 94 percent; the percentage of supplies currently present is in excess of 99 percent.7 In Norway, the current percentage of on-hand major end item equipment (Class VII) measured against authorized allowances is 47 percent; the percentage of on- hand supplies is 78 percent.8 It is important to note that these programs are not just a strategic war reserve. Marine Corps prepositioning programs support forward-deployed training exercises and, along with the amphibious ships of the U.S. Navy, the steady state requirements of the combatant commanders. For example, using the equipment positioned in Norway, the Marine Corps provides security force assistance to partner nations in U.S. European Command and U.S. Africa Command. In summary, Marine Corps prepositioning programs are vital to the Nation and they require the continued funding and support of Congress. Infrastructure Bachelor Housing.—Our number one priority in military construction is barracks. In years past, due to fiscal constraints, we had focused on operational concerns. We now have a program under way that will provide adequate bachelor housing for our entire force by 2014. Table 3 depicts Marine Corps fiscal year 2011 investment in new barracks. TABLE 3.—USMC FISCAL YEAR 2011 BARRACKS CONSTRUCTION [Dollars in millions]

Fiscal Year Location 2011 Invest- New Barracks ment Spaces

Twentynine Palms, CA ...... $53.2 384 Camp Lejeune, NC ...... 326.6 2,794 Cherry Point, NC ...... 42.5 464 Camp Pendleton, CA ...... 79.9 860 MCB Hawaii, HI ...... 90.5 214 MCB Quantico, VA ...... 37.8 300

Total ...... 630.5 5,016

—The Marine Corps is committed to funding the replacement of barracks fur- nishings on a 7-year cycle and to funding the repair and maintenance of existing barracks to improve the quality of life of Marines. Summary Our equipment shortfalls are serious and the impacts on readiness have been significant. Our non-deployed units do not have the required amount of equipment they need to train or support other contingencies. Moreover, the harsh environments of Iraq and Afghanistan, the tempo of operations, and our employment as a second land army since 2004 has accelerated wear and tear on our equipment and delayed the reset activities necessary to prepare for the next contingency. We estimate that the cost of restructuring the Marine Corps’ tables of equipment from fiscal year 2012 through fiscal year 2015 would be $5 billion and the cost to reset for the Marine Corps will be $8 billion ($3 billion requested in fiscal year11 OCO and an additional $5 billion reset liability upon termination of the conflict). Iraq and Afghanistan have not adversely affected personnel readiness or the resiliency of the force. The Marine Corps continues to recruit and retain the highest quality people. Your Marines want to make a difference; they understand being a Marine means deploying and fighting our Nation’s battles. Indeed, the Marines with the highest morale are those currently in Afghanistan.

7 Data as of February 18, 2010. To clarify any misperceptions, these are not the formal readiness percentages the Marine Corps uses in separate reports to Joint Chiefs of Staff, the Office of the Secretary of Defense, and Congress. The readiness percentages in those reports are a measurement against MARES reportable items, a more select range of equipment. 8 Data as of February 18, 2010. 211

The Marine Corps has achieved its goal of 202,000 active duty personnel and has done so with no compromise in quality. However, the Marine Corps has not achieved the correct mix of skills and pay grades. Continued funding will be needed to balance the force correctly. Our personnel growth has outpaced our growth in infrastructure, and your continued support is needed to provide the additional barracks, messing, and office spaces required.

MODERNIZATION OF THE MAGTF Our modernization effort is not merely a collection of programs but a means of aligning the core capabilities of the MAGTF across the spectrum of present and future security challenges. All of our procurement programs are designed to support the full range of military operations. The Individual Marine.—Marines are the heart and soul of your Corps. The trained, educated, and physically fit Marine enables the Corps to operate in urban areas, mountains, deserts, or jungles. However, we are concerned about weight. De- pending on the enemy situation, and including helmet, body armor, individual weapon, water, ammunition, and batteries, the weight of gear for a Marine on foot-patrol in Afghanistan can average 90 pounds. There is a delicate balance between weight and protection, and we continue to pursue the latest in technology to provide Ma- rines with scalable protection based on the mission and threat. Tactical Vehicles.—The Marine Corps currently has a total ground tactical vehicle quantity of nearly 47,500. Over the next 10 years, we plan to replace about 50 percent of that total. —We are planning, programming, and budgeting toward a balanced fleet of vehicles. Our chief considerations are mobility, survivability, payload, transport- ability, and sustainability. Our goal is a portfolio of vehicles that is able to support amphibious operations, irregular warfare, and operations ashore across the range of military operations. We envision a blend of Expeditionary Fighting Ve- hicles, Marine Personnel Carriers, Mine Resistant Ambush Protected vehicles (MRAPs), and replacements for our High Mobility Multipurpose Wheeled Vehi- cles (HMMWVs). —The Expeditionary Fighting Vehicle (EFV) is the number one modernization program in the ground combat element of the MAGTF. The requirements of the current and future security environment have driven the research and development of the critical capabilities associated with the EFV. The Marine Corps has not taken a myopic view of the EFV; we are well aware of the fiscal realities and developmental challenges associated with such a revolutionary vehicle. We are, however, convinced that national security demands the capabilities of the EFV and justifies the costs. This vehicle will save lives and enable mission success across an extremely wide, and highly probable, range of operational scenarios. Fire Support.—We are modernizing Marine Corps land-based fire support through a triad of weapons systems—a new and more capable 155 mm howitzer, a system of land-based rockets, and a helicopter-transportable 120 mm mortar. Each of these is extremely accurate. This accuracy is critical in counterinsurgency operations and irregular warfare because accuracy reduces the instances of civilian casualties and collateral damage to local infrastructure. —The Lightweight 155 mm Towed Howitzer (M777) weighs about half of the can- non it is replacing and fires projectiles to a range of 15–19 miles. Our Marine Expeditionary Brigade in Afghanistan has 15 of these howitzers at three different locations, which have collectively fired more than 600 rounds since April 2009. —The High Mobility Artillery Rocket System (M142 HIMARS) provides high- value rocket and missile fire in support of ground forces. Each system carries six rockets or one missile. Like our new lightweight howitzer, HIMARS has proven itself over the past year in Afghanistan, delivering long-range precision fires. —The Expeditionary Fire Support System is a rifled 120 mm mortar, internally transportable 110 nautical miles by both the MV–22 Osprey and the CH–53E helicopter. This will be the primary indirect fire-support system for helicopter- transported elements of the ground combat element. A platoon equipped with these new mortars recently deployed with the 24th Marine Expeditionary Unit. Marine Aviation.—Marine pilots are naval aviators; they are trained to fly from the ships of the U.S. Navy or from expeditionary airfields ashore in support of Ma- rines on the ground. We are in the midst of an unprecedented modernization effort. By 2020, we will have: 212

—Transitioned more than 50 percent of our aviation squadrons to new aircraft. —Added 5 more operational squadrons and almost 100 more aircraft to our inventory. —Completed fielding of the tilt-rotor MV–22 Osprey and the upgraded Huey (UH– 1Y) utility helicopter. —Updated our entire fleet of aerial refuelers to the KC–130J model. —Fielded the upgraded Cobra (AH–1Z) attack helicopter and the Joint Strike Fighter (F–35B). —Fielded an entirely new family of Unmanned Aircraft Systems (UAS). —Introduced a new model of the heavy-lift CH–53 cargo helicopter. The Joint Strike Fighter.—The Marine Corps is on track to activate the Depart- ment of Defense’s first operational Joint Strike Fighter squadron in 2012. Although our investment in this program may seem high, it is important to note that the Ma- rine Corps has not bought a fixed-wing tactical aircraft in 11 years, and that the Joint Strike Fighter will ultimately replace three different types of aircraft currently in our inventory. —The short takeoff and vertical landing (STOVL) variant (F–35B) of the Joint Strike Fighter will be transportable aboard the amphibious ships of the U.S. Navy; it will be able to operate under the same austere conditions as does the AV–8 Harrier; it will be able to carry more bombs and loiter overhead longer than does the F/A–18 Hornet; and it will be a better electronic warfare platform than our legacy EA–6 Prowler. The Osprey.—We are very pleased with the performance of the tilt-rotor MV–22 Osprey. The Osprey provides greater speed, more range, and enhanced survivability compared to other rotary wing platforms. It flies more than twice as fast and carries three times the payload at more than six times the range of the medium-lift helicopter it is replacing. —Osprey squadrons have completed three successful deployments to Iraq and one aboard ship. One squadron is currently in Afghanistan. We are nearing delivery of our 100th operational aircraft, and at a current build of 30 Ospreys per year, we are replacing our CH–46E medium-lift helicopter squadrons at a rate of two squadrons per year. Logistics Command and Control.—Global Combat Service Support System—Ma- rine Corps is the cornerstone of our logistics modernization strategy. —The program is a portfolio of information technology systems that will support logistics command and control, joint logistics interoperability, secure access to information, and overall visibility of logistics data. It will align Marine Corps logistics with real-world challenges, where speed and information have replaced mass and footprint as the foremost attributes of combat operations; it will replace 30-year old legacy supply and maintenance information technology systems; and it will provide the backbone for all logistics information for the MAGTF.

VISION The current transnational struggle against violent extremism will not end anytime soon. Other threats—conventional and irregular—will continue to emerge and the complexity of the future operating environment will only increase. As we look to the future, we believe we must refocus on our core competencies, especially combined-arms training and operations at sea with the United States Navy. 2010 Quadrennial Defense Review.—We believe the report from the Quadrennial Defense Review offers an accurate and informed analysis of the challenges in the future security environment, particularly with respect to growing complexity of hybrid threats and the spread of advanced anti-access capabilities. —We concur with the overarching need for a comprehensive and balanced approach to national security—a whole of government approach. —We agree with the need for a U.S. military that is balanced in capabilities for irregular warfare and conventional conflict. For the Marine Corps, we have always believed in such a balance. Our equipment and major programs, and our means of employment as an integrated MAGTF, reflect our commitment to be flexible in the face of uncertainty. One hundred percent of our procurement can be employed either in a hybrid conflict or in conventional combat. —Finally, while our current focus is rightly on today’s fights, we believe it is critical that we do not underestimate the need to maintain the ability to gain access in any contested region of the world. Seabasing and the Navy-Marine Corps Team.—With oceans comprising about 70 percent of the earth’s surface and the world’s populations located primarily on the coasts, seabasing allows our Nation to conduct crucial joint operations from the sea. 213

—Seabasing is a capability and a concept. It is the establishment of a mobile port, airfield, and replenishment capability at sea that supports operations ashore. In effect, seabasing moves traditional land-based logistics functions offshore. —From the sea, U.S. forces will be able to conduct the full range of military operations, from disaster relief and humanitarian assistance to irregular warfare and major combat operations. Sea-based logistics, sea-based fire support, and the use of the ocean as a medium for tactical and operational maneuver permit U.S. forces to move directly from sea to objectives ashore. —There are misperceptions that the United States has not conducted an amphibious operation since Inchon during the Korean War in 1950. Since 1982, our Na- tion has conducted more than 100 amphibious operations. For example, the Navy-Marine Corps Team has been on the scene in Bangladesh (1991), the Phil- ippines (1991), Liberia (1996), and East Timor (1999). —After 9/11, U.S. amphibious forces, from a seabase, led the first conventional strikes against the Taliban in Afghanistan. —In 2004, the 15th Marine Expeditionary Unit was on station in Southeast Asia to support the relief efforts after the Tsunami. —In 2005, from a seabase in the Gulf of Mexico, the Navy and Marine Corps supported recovery efforts after Hurricane Katrina. —In 2009, off the coast of Somalia, when pirates boarded the Maersk Alabama, the 13th Marine Expeditionary Unit and the U.S.S. Boxer were on station to support the counterpiracy operations. —Last month, with Haiti’s airfield overwhelmed and their seaport disabled by wreckage following the earthquake, the U.S.S. Bataan Amphibious Ready Group and the 22nd Marine Expeditionary Unit provided a significant and sustainable delivery of food, water, and other supplies without the logistical burden ashore. Seabasing—Maritime Prepositioning Force (MPF) Enhancements Critical to seabasing are the logistics vessels of the Maritime Prepositioning Force. As discussed in the Long-Range Plan for Naval Vessels, we have restructured our Maritime Prepositioned Force (Future) program and will enhance the current capabilities of each of our three existing Maritime Preposition Force Squadrons. One mobile landing platform (MLP), one Large Medium-Speed Roll-on/Roll-off (LMSR) ship, and one Lewis and Clark class (T–AKE) cargo ship will be added to each squadron of the MPF. The MLP will interface with the LMSRs, which are being added to each MPF squadron from fiscal year 2009–11, thus providing the capability to transfer cargo while at sea and making each MPF squadron highly responsive to demands across the full-spectrum of operations. In summary, as the security environment grows more complex, so does the value of amphibious forces. Expeditionary Operations in the Littoral Domain.—The littoral domain is where the land and sea meet. This is where seaborne commerce originates and where most of the world lives. Littorals include straits—strategic chokepoints that offer potential control of the world’s sea lanes of communication. The Navy-Marine Corps team and the vitality of the amphibious fleet is critical to overcoming anti-access challenges in locations along the coastlines of the world where there are no American military forces or basing agreements. —The QDR emphasized the need for U.S. naval forces to be capable of robust forward presence and power projection operations, while adding capability and capacity for working with a wide range of partner navies. Amphibious forces are perfectly suited for engagement and security force assistance missions, as well as humanitarian missions such as are ongoing in Haiti. In short, the strategic rebalancing directed in the QDR places high demands on our amphibious forces. —Given the fiscal constraints facing the Department of the Navy, the Secretary of the Navy, Chief of Naval Operations, and I agreed that 33 amphibious ships represents the limit of acceptable risk in meeting the 38-ship requirement we established in a letter to the committee on January 7, 2009. —We currently have a 31-ship force in the U.S. amphibious fleet. The Long-Range Plan for Naval Vessels projects a 33 ship amphibious inventory in the near- term. —With a robust inventory of amphibious ships the Navy-Marine Corps team will be able to: —Better address the growing steady state combatant commander requirement for theater security cooperation, forward presence, and crisis response. —Strengthen our Nation’s relations with allied and partner countries through peacetime engagement and training exercises. 214

—Better ensure our Nation is ready to respond with humanitarian assistance when disaster strikes anywhere around the globe. —In the event of major conflict, improve our response time to gain theater access with combat forces without having to rely on basing agreements with foreign governments. —Finally, to clarify any misperceptions about the numbers of amphibious ships cited in the 2010 QDR Report, those numbers of ships are neither shipbuilding requirements nor targets; they are simply statements of the amphibious ship numbers across the fiscal year 2011–2015 future years defense program.9 Training, Education, and Professional Development ‘‘Two-Fisted Fighters’’.—The QDR Report calls for increased counterinsurgency capacity in the general purpose forces of the United States.10 The Marine Corps has long recognized the special skills required to operate with host nation forces and among local populations. Evidence of this dates back to the Marine Corps publications of Small Wars Operations (1935) and the Small Wars Manual (1940), both comprehensive texts on counterinsurgency operations and irregular warfare. Today, through standing Marine Corps organizations such as the Center for Advanced Operational Culture Learning and the Center for Irregular Warfare, and programs such as the International Affairs Officers Program, we continue to build capacity in foreign language, and regional and cultural skills.11 Leadership Development.—We recognize the need for a diversity of skills and specialties, and our standing guidance to promotion, command, and special selection boards is to give due consideration to personnel with special skills and non-traditional career patterns. Marine Corps University.—Annually, a percentage of Marine Corps officers from the rank of captain through colonel attend year-long resident courses in professional military education at Marine Corps University in Quantico. The Marine Corps Uni- versity is regionally accredited to award postgraduate degrees and, in 2009 alone, University schools awarded 200 master’s degrees.12 —Facilities are an integral part of supporting professional military education. To that end, the Marine Corps fiscal year 2011 military construction budget request includes funding for additions in Quantico to the General Alfred M. Gray Research Center and the Staff NCO Academy. These projects will support our plan to upgrade the infrastructure of the Marine Corps University. Acquisition Professionals.—The Marine Corps has an active acquisition professional program in place to meet the need identified in the QDR ‘‘for technically trained personnel—cost estimators, systems engineers, and acquisition managers— to conduct effective oversight.’’ 13 There are about 520 acquisition billets in the Ma- rine Corps—400 are entry and mid-level positions filled by enlisted Marines and officers, and 120 are senior-level acquisition professional positions filled by field grade officers who oversee our major ground and aviation programs. Our acquisition professional officers are members of the Defense Acquisition Community; they possess Level II certification, four years of acquisition experience, at least 24 undergraduate credit hours in business. Future Realignment of Marine Forces in the Pacific.—The governments of the United States and Japan have agreed to invest in a realignment of forces that will result in Marine Corps forces postured in the Pacific for a long-term presence on Japan, Guam, and Hawaii. Critical requisites to the implementation of this realignment are:

9 Department of Defense, Quadrennial Defense Review (QDR Report) (Washington, DC: Feb. 2010), p. xvi, 46. 10 Department of Defense, Quadrennial Defense Review (QDR Report) (Washington, DC: Feb. 2010), pp. 20–26. 11 Each year, the Marine Corps selects officers for the International Affairs Officer Program, which consists of two professional tracks: Foreign Area Officer (FAO), and Regional Area Officer (RAO). The International Affairs Officer Program provides graduate-level study and language training for nine geographic areas. There are 329 international affairs officers on active duty (262 FAOs, 67 RAOs). The officers in this program possess advanced knowledge and expertise in the language, culture, and political-military affairs of a given region. Since 2008, the Marine Corps has doubled the number of accessions in the FAO program, and accessions will continue to increase through 2015. Moreover, the Marine Corps provides mid-grade officers (major—lieutenant colonel) for the Afghanistan-Pakistan (AFPAK) Hands Program. Our current requirement is to provide 63 officers—three cohorts of 21 officers each. 12 The Marine Corps also has a separate, voluntary graduate education program, through which officers attend Naval Postgraduate School and other secondary institutions to obtain advanced degrees. There are 300 officer billets in the Marine Corps that require master’s degrees. The Marine Corps also maintains an active fellowship program. 13 DOD, QDR, p. 76. 215

—Japanese construction of a replacement for Marine Corps Air Station Futenma that meets both operational and safety requirements. —An appropriate force laydown that supports the operational requirements of the Commander, U.S. Pacific Command. —Adequate available airlift and sealift within theater to transport Marines to training areas and partner countries. —Adequate training areas and ranges in Guam and the Northern Mariana Is- lands that can maintain readiness as well as support security cooperation with our regional partners. —An enduring, sustainable ‘‘live where you work,’’ base on Guam that maximizes operational effectiveness, minimizes encroachment, accommodates future development, and provides a quality of life on Guam commensurate with any other U.S. base. —Continued political and financial support by the governments of the United States and Japan. Refined planning and staff interaction processes within the Department of De- fense have made significant contributions to our efforts to align these requirements. Planned and executed properly, this realignment effort will result in an enduring solution that provides forward deployed combat ready Marine forces to uphold our Nation’s commitment to the security and stability of the Pacific region. Energy and Water Initiatives.—We believe energy and water are two of our Na- tion’s most valuable resources. We are focused on improving our stewardship at our installations and on the battlefield. —Our Installations.—We have already gained efficiencies and achieved savings at all our major installations. We have three major goals: —From 2003–2015, reduce energy consumption by 30 percent. —Through 2020, reduce water consumption by 2 percent per year. —By 2020, increase the use of alternative energy at our installations to 50 percent of the total energy consumed. —On the Battlefield.—Operations in Afghanistan have forced us to reevaluate energy and water distribution and usage in expeditionary environments. We believe the future security environment will again require the Marine Corps to operate over long distances in austere environments, and we are actively pursuing a wide range of solutions to: —Lighten the combat load of our Marines and Sailors. —Reduce our overall footprint in current and future expeditionary operations. —Lessen energy consumption and dependence on fossil fuels. —Achieve resource self-sufficiency in expeditionary environments.

CONCLUSION As a naval expeditionary force in the form of an elite air-ground team, the Marine Corps is ready and willing to go into harm’s way on short notice and do what is necessary to make our country safe. America expects this of her Marines. In the complex and dangerous security environment of the future, the Marine Corps stands ready for the challenges ahead. We appreciate the continued support of Congress. Thank you again for this opportunity to report on the posture of your Marine Corps.

PRESIDENT’S BUDGET REQUEST Chairman INOUYE. I will be submitting questions of a technical nature on weapons systems and ships, but I’d like to ask some broad questions. Mr. Secretary, you spoke very generously on the good things that we are providing, but I’m certain you have challenges. I’d like to know if you’re really satisfied with the budget request. Mr. MABUS. Mr. Chairman, we are exceptionally satisfied with this budget request. We believe that the budget that has been submitted will allow us to do all the missions that we have been tasked to do. It will allow us to buy the equipment that we need for those missions. It will allow us to maintain the equipment that we have today, to make sure that it reaches the end of its lifecycle. The budget request that we have in, over the next 5 years, will buy, as the CNO said, an average of 10 ships per year, beginning to move our fleet toward the level that we believe it needs to be. 216 In aircraft procurement, a little over 1,000 aircraft over the 5 years to meet those requirements. In terms of people, this budget meets the needs for taking care of our sailors and marines, both in terms of deployed missions and also in terms of their families at home station. It also takes care of the research and development needs that we have to pursue to make sure that we continue to be at the forefront of new technologies and emerging weapon systems. So, we believe this is a very good budget. We believe that it will allow us to do everything that we need to do, and we believe that it was constructed using—making some hard choices, but making them in a way that ranked priorities and that all our high priorities have been met. Chairman INOUYE. I’m pleased to listen to your response. It makes us feel better. SHIP COUNT But, if I may ask the Admiral—I come from a State surrounded by the ocean, so Navy has been part of my life. And I recall, not too long ago—that about 25, 30 years ago—we were speaking of a 600-ship Navy. Now you have a 313 ship-for-tomorrow’s Navy. But, the Navy is all over the globe. In fact, just a few weeks ago, I was in Afghanistan, and there I saw Navy personnel—sailors and officers—right in the middle of Afghanistan, running a hospital, training troops. Do we have enough ships? Do we have enough equipment for all of these activities all over the world? Admiral ROUGHEAD. Thank you, Senator. And, as you pointed out, the objective that we have for the fleet size is of what I call the ‘‘floor’’ of 313 ships. Right now, we have 286. The shipbuilding program puts us on the trajectory to get to that 313 ship floor that is—that addresses the many needs that our Navy has around the globe. If we meet that floor of 313, I’m comfortable that we will be able to address the Nation’s requirements. That said, that 313 ship floor must be of the proper balance to be able to meet the mission requirements, not just with the largest capital ships, such as our aircraft carriers, but the value that our submarine force provides is extraordinarily important. The amphibious ships that support our marines in their operations, that can also be used for some humanitarian activity, when we’re called upon to do so, as we have been, seemingly, every year in the last decade. But, it’s important to get to 313 ships. That will give us the capacity we need, but the balance must be right, to give us the capabilities that we need. SUICIDES Chairman INOUYE. The subcommittee’s very impressed by your recruiting and retention numbers, but I must say, honestly, that we were set back a little when we read the numbers on suicides. Do you have anything to tell us about that? Admiral ROUGHEAD. Yes, sir. Suicide is a problem that all the services deal with. Indeed, I think society deals with. While it’s too early, I think, to call it a trend, as a result of some of the programs that we have put in place, the engagement with leadership over the past few months, starting in January, we’ve 217 seen some very encouraging signs, as suicide numbers in the Navy are not replicating what we had last year. In January, in our Ac- tive Force, we did not have a suicide. February—we are down from February of a year ago, and I can say the same for this year. But, it is something that requires a great deal of attention. The Navy’s demographic is somewhat different, in that our suicides tend to be more senior. But, they have a common thread, for the most part: personal problems, personal issues. Mix the use of alcohol in with that and a firearm, and you have homed in on about 74 percent of our suicides. We are going to be relentless in getting at this problem. But, I do see some encouraging signs in where we have gone in the last few months in the Navy. Chairman INOUYE. So, the suicide rates are not necessarily based upon deployment. Admiral ROUGHEAD. No, sir. And in our case, they are not necessarily driven by deployments. We’ve been looking for various cor- relations. As I mentioned, our demographic of suicides seem—they seem to be more senior, not necessarily deployment driven. How- ever, if there is a suicide relative to a deployment, it—a higher probability occurs within 6 months of return. But, for the most part, ours are not a function of deployments. In many instances, we have young men and women who take their lives who have not deployed. So, we’re looking at all the possible drivers and methods to get at this issue. MARINE CORPS RECRUITING AND RETENTION Chairman INOUYE. Thank you very much, Admiral. And, General, if I may. We’re very much impressed by the activities of the Marine Corps. You’re all over the globe. General CONWAY. Yes, sir. Chairman INOUYE. You’re in Haiti, you’re in Afghanistan. But, yet, you’re having no problems with recruiting and retaining. What’s your secret? General CONWAY. Sir, I think there’s a culture there that we provide to some very incredible young men and women in our country that simply makes them want to become marines. I—as I mentioned in my opening statement, the biggest problem I have, as the Commandant, is trying to find a way to get about 190,000 other marines who want to go to Afghanistan, to Afghani- stan. And those are the nature of the people that we seem to attract. We work hard at it. I’ll say that. We’ve got some tremendous recruiters in the field. I would in no way discount their efforts. We’re tied into a very good advertising agency in New York City that’s been with us now for, I guess, close to 60 years. But, I just have to think, sir, that there’s a great young strain of Americans out there that see the need to defend their country’s vital interests, and are more than willing to step up to do so. MARINE CORPS RESET/RECONSTITUTION Chairman INOUYE. I note that, in your resetting and reconsti- tuting of the Marine Corps, it’s getting bigger, for one thing, and having different missions. Are you having problems with that change? 218

General CONWAY. Sir, to the extent that we’re not staying up with our equipment, we are. As I referenced in my opening statement, we have what I would call a ‘‘rolling requirement.’’ In other words, every day that we’re in a fight in Afghanistan now, we’re going to have equipment damaged, equipment that is undergoing some tremendous usage rates and those manner of things. There’s equipment density there that we just have not seen before in previous conflict, based upon what we now would call our ‘‘distributed operations’’ that we’re conducting today over large areas of landmass. Those marines at the point of the spear will have everything they need. But, in the process, the bill payers, which, for the most part, are our base and station units at home, are starting to see some real concerns with regard to the readiness rates. Congress has been, I think, generous in the past, it’s fair to say. We were kept at about 75 percent of that requirement over the previous years. Today we’re only at about 50 percent. Congress has told us that, when we are finished with that fight in Afghanistan, and, God forbid, any others, that there will be a 2- or a 3-year period where we can get healthy again, both the Army and the Ma- rine Corps, principally, with regard to our equipment sets. But, I’ll paraphrase my Secretary and say that I think our Na- tion is going to face hard choices at that point, based upon the national fiscal picture. And I would advocate, sir, that, before that time, starting as soon as possible, that we try to get caught up again and essentially do in-stride kinds of reset and reconstitution of our equipment sets. Chairman INOUYE. Well, thank you very much. Senator Cochran. TECHNOLOGY Senator COCHRAN. Mr. Chairman, thank you. Mr. Secretary, there is a lot of pressure on the budget, because of modernization efforts and things that are being planned to make our Navy and Marine Corps team more sophisticated, with newer component parts and advanced systems for both reconnaissance and combat activities that may be required of these services. What is the status of some of our efforts to take advantage of new technologies, like composites and polymer science initiatives, that provide us with more modern coatings for ships, and efficient operations? Is this something that is a part of our R&D effort that’s funded in this budget? Or is more money needed to be appropriated for these kinds of activities to make us more modern and capable? Mr. MABUS. Senator, this—those kinds of activities are funded in this budget, and I’ll give you some—a few specific examples of that. One is on energy savings, energy efficiency. We’ve done a lot of work and are continuing to do work on hull coatings and hull technologies, and particularly in the polymer area. When you combine that with some stern flaps and missions planning tools, you can cut down the use of fuel on our ships pretty substantially. The DDG 1000 program has a completely composite superstructure, for example. We’re looking at other ways to use those sorts of technologies. The move toward polymers, toward different sorts of materials that are stronger, more resilient, that can withstand different sorts 219 of pressures, is one of the focuses of what we are doing. It is—as always, the challenge is to make those requirements come into the budget and to—and one of the ways we’re trying to do that is—as new technologies such as this come forward—is to incorporate them into existing designs, into existing hull forms, so that we don’t have new ship classes coming out with the resultant more expensive first and second ships in the class. But, to finish the answer, things like new advances in polymers, and all across the spectrum of science, are something that we’re focused on. We’re asking for a little over $17 billion in fiscal year 2011 to continue the R&D in all sorts of areas, but polymers is certainly one of those. Senator COCHRAN. General Conway, I recently had an opportunity to be briefed and see a—some demonstration techniques of new bullet-resistant vests and body armor, I guess you could call it. It didn’t look like old-timey armor. You didn’t—you couldn’t tell by looking at the material that it had the capability of resisting injury from fired weapons. Is this something the Marine Corps is involved in? And to what extent are our troops benefiting from research and development of new capabilities for defense of this kind? General CONWAY. Sir, the short answer to your question is that we’re heavily involved in it. And as an adjunct to, again, the Sec- retary’s answer, we are branching out, as it pertains to our equipment, to try to accomplish better sets of gear through advanced technology. And I’ll give you two or three examples. We have endeavored to find a helmet, since I’ve been the Com- mandant, that will stop 7.62 caliber rounds, which is the enemy’s primary rifle bullet. We’re close, but we’re not there yet. And yet, it is, in many regards, my number one procurement priority. It’s simply a matter of technology and industry being able to put the polymers together, we think, and make it work. Now, to your point on protection in vests. We have, now, what we call ‘‘small arms protective insert (SAPI) plates.’’ There’s an enhanced SAPI plate, and there’s even an X–SAPI out there that will stop, supposedly, Chinese ceramic bullets. Well, sir, I’ve never seen a Chinese ceramic bullet, and we’re not willing to forego the weight that that extra plate would create. So, we’re looking for lightweight kinds of technological advancement that will, ideally, be flexible and give us the same level of protection that we have today in these fairly heavy and very rigid plates. Another area is the joint light tactical vehicle. It was going to be light because it was going to have new age armor, as opposed to plated steel. And yet, again, for all of the expense and resources that we apply against it, industry tells us that we’re probably still 5 years away from that type of development. So, sir, we’re pushing hard for those things that we think will enhance the force, but in some ways, the science is just not there. Senator COCHRAN. Well, we don’t want to drop the ball here on this side of the table, either. If we need additional funding or some priority readjustments, we hope you’ll communicate that with us in the appropriate way. General CONWAY. Thank you, sir. 220

SHIP COUNT/MISSION REQUIREMENTS Senator COCHRAN. Admiral Roughead, you had experienced that on the Mississippi gulf coast, I know, when you were commanding officer of a ship that was built at Ingalls, when we first got to meet you, and we appreciate your distinguished service as Chief of Naval Operations. Now, what is the status of the readiness of our ship — the obligations and needs of our Navy vessels? Do we have enough ships? Is our construction schedule sufficient to enable us to carry out our responsibilities around the world? Admiral ROUGHEAD. Thank you, Senator. And I would say that, until we get to the floor of 313 ships, we’re going to be pressing the fleet that we have today pretty hard, as we currently are doing. But, the shipbuilding program that we have presented to this subcommittee puts us on that proper trajectory. I would say that there are two elements in there that are key to the future. One is the restart of the DDG 51 class destroyer. That allows us to address the ballistic missile threats that are proliferating around the world, as well as the more advanced cruise missiles. The restart of that class of ship gives us the capabilities we need, and then it allows us to backfit that rather large class. So, now we have the capacity that is so very important, and then— and we have the capability that’s there. The other element that’s going to be extremely important is that we get to a good, quick, clean down-select, so that we can begin to produce littoral combat ships in the numbers that we need to meet the obligations that we have around the world. That ship, whatever design it may be, is going to be a workhorse for us, and it will generate the numbers that we need. I’m also very pleased that this year’s budget starts the production of two Virginia class submarines a year. Submarines remain in great demand. Submarines are a capability that gives us a cutting edge in naval warfare, and the Virginia class submarine that we’re building now is an extraordinary submarine. But, I would also say there’s something more that gets to force structure, and that is our operation and maintenance account. It’s all very interesting to look at how many ships we’re buying and building a year, but if we do not maintain the fleet that we have today, then those numbers will be disappearing from the books faster than we expected, and our fleet size will begin to drop off. And that’s why it’s important that we properly fund the fleet that we have today, with our operation and maintenance accounts. I’m a fleet sailor, and I have paid a great deal of attention, since becoming the CNO on what does it cost to maintain the fleet that we have today, to get the life we need, to get the readiness that we need, and not put work on the backs of our sailors because we’re not properly funding shipyard maintenance. And so, this year’s budget has a significant increase in it. That increase is the cost that we need to maintain the fleet that we have today. And that is something that I ask for your strong support in, sir. Senator COCHRAN. Well, thank you very much for your leadership and your response to our questions. 221 Thank you, Mr. Chairman. Chairman INOUYE. Thank you. Senator Bond. AVIATION Senator BOND. Thank you very much, Mr. Chairman. Mr. Secretary, I applaud your statement about demanding on- time, on-budget acquisition, that you would terminate a program that was substandard or with a cost escalation, much as I said in my opening statement, quoting the Secretary of Defense. I trust that you either watch or read the transcript of the F–35 hearing held last Thursday. Stated many times by witnesses that, best-case scenario, ‘‘if everything goes perfect,’’ the Navy’s JSF will be in initial operating capability, IOC, in 2016. It was also stated that the Navy Strike Fighter shortfall of 100 is no longer accurate, since the JSF restructuring plan. And as far as budget—cost escalation, I believe an accurate cost accounting would show that the JSF not only has breached the initial threshold of Nunn-McCurdy, but will have gone past it. If it hasn’t, it will be soon. When you’re taking production dollars to go into continued testing, something is very wrong. And knowing these facts, do you think the Navy need only purchase F/A–18s on a year-by-year, case-by-case basis, or would it better to enter into a multiyear contract which would save hundreds of millions of dollars for American taxpayers? Mr. MABUS. Thank you, Senator. Because of the—what Congress has provided to the Navy in fiscal year 2010, in terms of F/A–18s, both E, Fs, and Gs, and our budget request, which, counting fiscal year 2010, is for 124 F/A– 18 E, F, and Gs, we received, the last week of February, a proposal from the contractor for a multiyear procurement. Congress had allowed us to look at a multiyear procurement on the F/A–18. That proposal, on its face, met the 10-percent savings requirement for a multiyear, but it is, right now, in—looking at the details to make sure that the requirements are met, it’s with the Cost Analysis and Program Evaluation Office in DOD. Assuming that those thresholds for a multiyear procurement are met, we would be very eager to enter into a multiyear, and we’ll be coming back to Congress to ask for permission to do that, assuming those thresholds are met. Senator BOND. Thank you very much, Mr. Secretary. I think the only requirement that Congress would put on you is substantial savings. I don’t know—I believe that 10 percent is a figure that the Defense Department has come up with; I don’t think it is a statutory requirement. But, in any event, so long as you would see a substantial savings, I would think it would be a good investment. Admiral, given the conditions of last year and the TACAIR shortfall, if you don’t continue, with major purchases of the F/A–18s, to address the shortfall, what will the shortfall for the Navy’s carriers be by about 2015 or some period along in there? Do you have that information? Admiral ROUGHEAD. Yes, sir. We’re still looking at the shortfall of being in that area, around 100. And the reason I say that is that, even though we have slipped the JSF in what appears to be a calendar slip of 2 years—2014 to 2016—it really looks to be about 222 13 months, because we’re going from December 2014 to January 2016. That still allows us to deploy the Joint Strike Fighter in 2016, as we planned. It deploys first on one of our Pacific Fleet carriers. But, we’re continuing to look at the Joint Strike Fighter production. We, in the Navy, have somewhat of an advantage, because we’re the third service in line to get it. So, a lot of the testing that will go forward early on Joint Strike Fighter, we’ll be benefiting from that. And we’re looking at getting the IOC in January 2016. Senator BOND. It’s interesting you say that, because last year at Souda Bay, I talked with a master chief petty officer who was very familiar with it, and he thought that the JSF will never operate off of a carrier, because of the backblast and a lack of operating— of area to service the airplane. So, I think the testing is continuing, but I think there’s a final question of whether it will work on shipboard. Now, I know that there’s been a proposal for service-life extension. And are you considering that? I gather it will add only about 1,400 hours to an older Hornet, which is at $26—$18—$12 to $26 million, it would be about one-half of a Super Hornet. If you’re considering a service life extension program (SLEP), isn’t a purchase of a new aircraft a better option, better bargain for the taxpayers? Admiral ROUGHEAD. Senator, if I could just touch on the—comment on the Joint Strike Fighter on the carrier. Our carrier—the carrier variant of the Joint Strike Fighter is compatible with carrier operations. I think the chief may have been talking about the short takeoff and landing aircraft. But, our carrier variant is compatible. We may have to make some adjustments to the jet-blast deflector that we use in the launch of the airplane, but it’s compatible. With regard to the Service Life Extension Program, as we go into the 2012 budget, we’re going to be taking a very, very close look at the—managing the strike fighters that we have. SLEP is where I’m going to be looking, because I can generate more strike fighters at less cost for a period of time to do that. And that’s something that we’re going to be getting into in the 2012 budget. Senator BOND. Well, we appreciate that you’re looking at that. And, Mr. Chairman, I’d like to submit for the record, a letter I have written to the Secretary of Defense today which addresses these issues that I have raised. And I thank you very much. Chairman INOUYE. So ordered. Senator BOND. Thank our witnesses very much. [The information follows:] MARCH 17, 2010. The Honorable ROBERT M. GATES, Secretary of Defense, The Pentagon, Washington, D.C. 20301–1000. DEAR MR. SECRETARY: On February 26, 2010, the Department of Defense (DOD) wrote to the Senate Appropriations Defense Subcommittee its intentions to explore a multi-year procurement agreement for the purchase of F/A–18 series aircraft for fiscal years 2010 through 2013. I applaud the Department of the Navy for considering a multi-year procurement, a prudent move that would prevent the Navy from having empty carrier decks, save hundreds of millions in valuable taxpayer dollars, and maintain the strength of the United States defense industrial base. 223

As you know, the F/A–18 Hornets and Super Hornets are the backbone of the carrier-based strike fighter aviation fleet. These aircraft are providing support for our warfighters through close air support missions to ground forces with an unmatched deterrent capability. The F/A–18 aircraft continues to be the Navy’s only strike fighter with advanced air-to-ground and air-to-air operational capability. The continued procurement of these aircraft is necessary to continue the Navy’s warfighting operations. The majority of the F/A–18 Super Hornet aircraft have been purchased under two, multi-year procurements this past decade. With significant savings achieved from long-lead production and higher procurement rates, these agreements saved hundreds of millions of taxpayer dollars compared to more costly single-year procurements. The Navy’s own estimate stated that the multi-year procurements from fiscal year 2000 through fiscal year 2009 resulted in over $1.8 billion in savings. A third multi-year procurement agreement could save hundreds of millions more in taxpayer dollars, all of which could be applied to other pressing defense requirements. A third multi-year procurement for the F/A–18 Super Hornet aircraft also would ensure that the defense industrial base for tactical aviation is maintained through at least fiscal year 2013. In order for the United States military to maintain its current air dominance, the skills and experience of the aviation manufacturing sector must be protected for as long as possible into the future rather than curtailed. I strongly urge that you and the Department of the Navy take aggressive steps to enter into a multi-year procurement for the F/A–18 Super Hornet aircraft. I stand ready to assist you in that effort. Sincerely, CHRISTOPHER S. BOND. Senator Shelby. Senator SHELBY. Thank you, Mr. Chairman. LITTORAL COMBAT SHIP Mr. Secretary, I’m going to get into the littoral combat ship that the Admiral alluded to. A lot of us are concerned, Mr. Secretary, that the pending request for proposal for the next 10 littoral combat ships does not appear to take capability and lifecycle costs into consideration. The upfront acquisition price of the LCS, I believe, must be balanced against total ownership expenditures, and ne- glecting to evaluate these criteria may result in an inaccurate picture of the total costs associated with each ship. I’m concerned, Mr. Secretary, about fuel efficiency, which is a big cost—you mentioned this earlier, over in the Armed Services Com- mittee—being a critical factor of competitive cost evaluation. The two LCS designs are dramatically different in this respect, as you well know. Now, it’s my understanding—if the request for proposal is not amended, it would appear that the acquisition would go forward in a direct contradiction to the statement that you made before the Senate Armed Services Committee on February 25 that said, and I’ll quote your words, ‘‘I have also committed the Navy and Marine Corps to consider energy as a mandatory evaluation factor in contracting.’’ I’d like to see the request for proposal (RFP) amended, if it needs to be, to include an evaluation factor that provides for the consideration, as you mentioned, of energy consumption costs in the valuation and the source selection decision. As my letter to you on March 12 of this year stated, I’ve asked the Congressional Budget Office to review and to address the total lifecycle costs of the LCS Program. We haven’t gotten a response yet. Would you consider extending the April 12 submission date, considering your statement to the Armed Services Committee and our request to the Congressional Budget Office regarding this? Be- 224 cause, what we want is the best vessel for the Navy. Isn’t that right? And you have to consider all costs. Mr. MABUS. Thank you, Senator. Yes, sir, in terms of total ownership cost, the entire LCS was designed with that in mind. And we believe that the current RFP addresses the need for the Navy to get the best ship possible. Either variant, either LCS 1 or LCS 2, meets all the requirements that the Navy has, in terms of operation. And in terms of total ownership cost, if you look at everything, from the manning of the vessel, which, as you know, is about 40 sailors for the core crew, and the other things that go into total ownership cost, if you look also at the way these ships are to be used—at the profile the speeds that they will be used at while they’re at sea—where the fuel savings diverge is only at the very upper end of the speed of these ships. Senator SHELBY. But, that could be a lot of money, could it not? Mr. MABUS. Well, the profile that we’ve developed for these ships is that they would be used very infrequently at such high speeds. And so, I think that the current RFP, which stresses the cost to purchase the ship so that we can get enough of these ships—and both variants, we believe, meet every requirement that we have, not only operationally, but also in terms of lifecycle costs, going forward. Senator SHELBY. Mr. Secretary, where, in the request for proposal for the year 2010 LCS procurement, does the Navy consider the fuel differential in dollars between the two competing designs over the expected life of the program? Can you furnish this to me and for the subcommittee? Mr. MABUS. I’ll be happy to furnish you the technical aspects of that RFP. [The information follows:] The request for proposal (RFP) for the littoral combat ship (LCS) fiscal year 2010 block buy procurement does not specifically consider the fuel differential in dollars between the two competing designs. The RFP includes an evaluation factor under the technical/management category for Life Cycle Cost Reduction Initiatives. Since the inception of the LCS program, the Navy has focused on reducing both acquisition cost and life cycle cost in LCS class ships. In this regard, lifecycle cost considerations are emphasized in both designs through the Navy’s requirements for reduced manning, open architecture and missing package modularity that have been key design parameters since the inception of the program. Total Ownership considers research and development costs, investment costs, disposal costs, and operating and support costs including maintenance, manning, training, fuel, and infrastructure support. Fuel costs are an important contributor to the estimated life cycle cost for each ship design, but are also highly dependent on the speed-time profile assumed for the LCS mission. Senator SHELBY. That would be very interesting to get, because we’re interested in the total lifecycle cost. And you stand by your words, do you not, before the Armed Services Committee? Mr. MABUS. Yes, sir. Senator SHELBY. Okay. Mr. MABUS. And not only total lifecycle cost, in terms of manufacturing, but also what energy requirements the shipyards themselves use. That was the import of my words—— Senator SHELBY. Okay. Mr. MABUS [continuing]. Before the Armed Services Committee. Senator SHELBY. Thank you, Mr. Chairman. Chairman INOUYE. Senator Kohl. 225

Senator KOHL. Thank you very much, Mr. Chairman. Mr. Secretary and Admiral Roughead and General Conway, we thank you all for being here today. I’d like to congratulate the Navy on the successes the Marinette- built littoral combat ship, U.S.S. Freedom, has had in the Carib- bean. It’s already making a great contribution to the war on drugs, and you should be very proud; I know everybody in Wisconsin is. Just to review the previous questioning, Mr. Secretary, there are a lot of concerns being raised about the total ownership costs of the two competing LCS designs. And that, of course, is a fair thing to do, because we all want taxpayer dollars to be spent wisely. But, aren’t long-term costs already a part of the criteria that you will be using to evaluate these designs, which does include fuel consumption? I think you responded to the previous question that way. Mr. MABUS. Yes, sir, that’s correct. Senator KOHL. As far as fuel efficiency goes, don’t you now have real data on the first LCS, Freedom, and its fuel consumption, not just estimates? Is the ship’s fuel consumption about what you expected? Mr. MABUS. Yes, sir. Senator KOHL. Mr. Secretary, one of the concerns, as well, has been the experimental nature of the Austal ship design and use of aluminum as a building material. Aluminum is not traditional for Navy ships; it wears differently, and it melts, as we know, at lower temperatures. Compared to steel construction, how much experience does the Navy have estimating the maintenance costs, over decades, of aluminum ships? How much experience do you have evaluating the maintenance requirements Trimaran vessels? Mr. MABUS. In terms of aluminum, Senator, other ship types have been made out of aluminum for many years now. And looking at other ships that have been made this way, we have been able, we think, to look at what that will—what sort of maintenance will be required over time. And it’s because of things like that that we think that either variant of these—of the LCS will meet all our requirements, both in terms, as I said, of operations and in terms of lifecycle costs and maintenance, as we go forward. We don’t foresee any significant issues for either variant. And as the CNO said, and I want to echo this, it’s crucial to us to get the cost of these ships down so that we can buy the numbers that we need. We, over the 30-year shipbuilding plan, propose to buy 55 of these. They have become one of the backbones of the fleet. And we’re taking this exceptionally seriously, and we will pick the best ship for the Navy today and the Navy of the future. Senator KOHL. Thank you. Aren’t aluminum ships, Mr. Secretary, more expensive to fix, in part because not all shipyards have welders, or enough welders, trained to work on aluminum? Mr. MABUS. My understanding, Senator, is that welding for aluminum and welding for steel are very similar, and that the training required to do aluminum could be done in a normal course of events. Senator KOHL. Finally, I’d like to say, in closing, that this is an argument, as we know, about cost, but one of these ships, because of its radical design and nontraditional material, I believe, makes 226 it riskier and harder to determine the long-term costs. It seems, in a very real sense, that we’re comparing apples and oranges. But, I thank you for your testimony. I thank you for your frank- ness and your interest and your concern in making the correct decision. Thank you, Mr. Chairman. Mr. MABUS. Thank you, Senator.

WOMEN ON SUBMARINES

Chairman INOUYE. Thank you very much. I have one further question. I participated in an ancient war many years ago, and in that war, the women I saw were nurses, far away from the combat zone. But, today we have women in all branches, in all areas, and I commend the Department of Defense for that decision. However, recently, I’ve been receiving e-mail and letters on the decision to assign women on submarines. May I have your thoughts on that, sir? Admiral? Admiral ROUGHEAD. Yes, sir. I believe that the initiative that we have put forth, and have made notification to the Congress, that it’s our intent to incorporate women into our submarine force, is exactly the right thing to do. The young women who serve in the Navy today are absolutely extraordinary. There is great interest among the young women who serve, in joining our submarine force. In fact, just this past weekend, I was at a function, and a young woman came up and thanked the leadership for moving forward, and that she was putting in her papers to join. We have a very good plan to incorporate women into our submarine force, starting with our ballistic missile submarines and our guided missile submarines, the SSBNs and the SSGNs. The young women will begin in the officer ranks, attend nuclear power school, submarine school, and the plan has the first women coming aboard in 2011. The skill, the competence, the drive, the focus, and the dedication of the young women who serve today, I believe that this will enhance the capabilities of the force, and I look forward to being able to have this implemented before the end of 2011. Chairman INOUYE. I thank you very much, and I congratulate you on your decision. Admiral ROUGHEAD. Thank you, sir. Chairman INOUYE. Any further questions?

ADDITIONAL COMMITTEE QUESTIONS If not, Secretary Mabus, Admiral Roughead, General Conway, the subcommittee thanks you for your testimony today, and we thank you for your service to our country. And if we may, through you, thank the men and women in uniform who are willing to stand in harm’s way in behalf of us. Thank you very much. [The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:] 227

QUESTIONS SUBMITTED TO HON. RAY MABUS

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE Question. This year, the Navy began a major development effort on a new ballistic missile submarine to replace the aging Ohio-class. Nearly $6 billion is committed to designing the submarine over the next 5 years, and the cost of each submarine is expected to be $7 billion. Secretary Mabus, the Navy’s 30 Year Shipbuilding Plan projects an average of $15.9 billion in shipbuilding costs over the next three decades. What steps are being taken to insure that the new ballistic missile submarine will be affordable? Answer. Fiscal year 2011 funding continues the major U.S. investment in the Ohio-class replacement submarine started in fiscal year 2010. The key to an affordable future sea-based strategic deterrence fleet is the proper level of investment now in early design work and up-front critical research and development. Current efforts leverage a United Kingdom (U.K.) investment of $288 million (fiscal year 2008-fiscal year 2010), and synchronize with the U.K. efforts to develop a Common Missile Compartment (CMC). Cooperation with the U.K. mitigates technical risk and contributes to reducing acquisition cost. The Ohio Replacement Program will also leverage design and construction lessons learned and ongoing cost reduction initiatives from the Virginia Class Submarine Program. The Navy is managing the shipbuilding portfolio as a business unit and is looking for ways to better leverage its buying power, such as: —Leverage cost savings and value creation on basis of broader business arrange- ments across contracts and shipyards. —Evaluate each ship class and identify cost reduction opportunities while balancing warfighting requirements, costs, and industrial base realities. —Incorporate open architecture for hardware and software systems and increase the use of systems modularity. —Emphasize repeat builds of ships, commonality, cross-program buys, and design re-use to drive down costs. —Use contract incentives, such as multi-year procurements, fixed price contracts, and other mechanisms to increase competition at the vendor level. Question. Secretary Mabus, as you know, the Subcommittee has supported the Navy’s decision to end procurement of the DDG 1000 program and restart the DDG 51 program. I understand that in addition to restarting the DDG 51 program, the Navy now proposes to terminate the next generation cruiser in order to build an improved version of the DDG 51, the so-called Flight III. What are the industrial-base consequences of canceling the cruiser and instead building improved DDG–51’s? Answer. The President’s budget for fiscal year 2011 includes eight DDG 51 class ships, to be procured between 2011 and 2015. This shipbuilding plan, combined with the continued technology development of the Air and Missile Defense Radar (AMDR), offsets the industrial base consequences of canceling the next generation cruiser CG(X) and ensures stability for the industrial base in procuring future Navy surface combatants. CG(X) was envisioned to fulfill a critical role in Integrated Air and Missile Defense (IAMD). However, due to the ship’s projected high cost and the immaturity of its combat systems technology and still evolving joint Ballistic Missile Defense (BMD) architecture, the Navy determined that it is not feasible to continue to pursue a new-design CG(X) procurement program at this time. The increased demands for additional capability and capacity in IAMD make it critical to pursue the technology development and combat system design for application on a future combatant. Question. Secretary Mabus, you listed alternative energy as one of your top priorities upon taking office. This Committee has added more than $54 million over the past 3 years to Navy alternative energy initiatives and similar amounts to the other Services as well. This does not even begin to count the many dozens of alternative energy and energy efficiency earmarks the Congress has approved in the same period, or the substantial amounts of alternative energy funding contained in the stimulus bill. Could you please describe to the Committee your top energy initiatives, and how the fiscal year 2011 budget supports your plan? Answer. In October 2009, I established five energy goals within the Department of Navy (DON) that would aggressively reduce the amount of foreign oil consumed by DON: 228

—1. Acquisition Process Reform.—Evaluation factors when awarding contracts for platforms, weapons systems, and facilities will include lifecycle energy costs, fully-burdened cost of fuel, and contractors’ energy footprint; —2. Sail the ‘‘Great Green Fleet’’.—Demonstrate a Green Strike Group in local operations by 2012 and sail it in 2016. The Strike Group will be made up of nuclear vessels, surface combatant ships using biofuels and hybrid electric propulsion systems, and aircraft flying on biofuels; —3. Reduce Petroleum Use in Non-Tactical Vehicles.—By 2015, reduce petroleum use by 50 percent in commercial fleet through use of flex fuel vehicles, hybrid electric vehicles, and neighborhood electric vehicles; —4. Increase Alternative Energy use Ashore.—By 2020, produce at least 50 percent of shore-based requirements from alternative resources and 50 percent of all Naval installations will be Net Zero energy consumers; —5. Increase Alternative Energy Use Department Wide.—By 2020, 50 percent of total energy consumption will come from alternative resources. The President’s fiscal year 2011 budget request includes an additional $174 million to support these goals. The following describes this investment in detail: Research, Development, Testing and Evaluation—$40.9 million $7 million supports the Naval variable cycle engine technology program, which is focused on optimizing aviation engine performance at all operational conditions. This energy efficiency effort supports goals 2 and 5. $13.6 million for the Hybrid Electric Drive. The operating efficiency/fuel savings for DDG 51 class ships will be achieved by employing fewer gas turbines for propulsion and ship service power generation while also loading gas turbines to their optimal operating condition. The Hybrid Electric Drive supports goal 2. $20.3 million will fund various energy conservation programs in support of goals 2 and 5: —$1 million to establish an Incentivized-Energy Conservation (I–ENCON) for aviation programs. —$1.2 million to support a fleet scheduler plan in the Naval Ship Incentivized- Energy Conservation (I–ENCON). —$8 million to enhance F414 Engine Efficiency. —$3 million supports Aircraft Energy Efficiency Conservation R&D, including: —T–56 turbine, compressor, and inlet housing upgrades; —Development and testing of F/A–18 E/F flight management system. —$2 million supports the F/A–18 Bring Back Weight initiative to certify F/A– 18E/F & E/A–18G aircraft structures to increase carrier bring back weight. —$2.9 million supports high energy efficient HVAC systems. —$2.2 million supports improvements to the LCAC hovercraft. In addition to the $40.9 million outlined above, the Office of Naval Research will invest $136 million in fiscal year 2011 for power and energy programs that directly and indirectly support my energy initiatives, including a PB 2011 energy initiative focused primarily on alternative energy and biofuels. This investment will support goals 2, 3, 4, and 5. Procurement—$4.2 million $2.1 million for Navy variant Environmental Control Units (ECUs) to provide improved generator capabilities (to reduce log tail in theater). $2.1 million for Onboard Vehicle Power capability to use vehicles’ internal com- bustion engine to provide power for communication and auxiliary systems, situational awareness devices, environmental control, and other electric powered accessories. These efforts support goals 3 and 5. Operation and Maintenance—$96 million Will fund advanced metering efforts, facilities energy efficiency upgrades, and continue energy audits, all in support of goals 4 and 5. National Defense Sealift Fund—$3.3 million Includes Military Sealift Command’s initiatives to include Energy Audits and evaluation of other technology currently being used by the shipping industry to more efficiently plan routes, monitor energy usage, realize cost savings for fuel burned reaching ships in theater. These efforts support goals 2, 4, and 5. Military Construction—$30 million Three $10 million solar arrays will be constructed at MCRD San Diego, Cali- fornia; MCB Camp Pendleton, California; and MCB Camp Lejeune, North Carolina. These projects support goals 4 and 5. 229

Question. Secretary Mabus, are there enough engineers and tradesmen trained in ‘‘green collar jobs’’ to support your goals for increasing energy efficiency and research into alternative power sources? Answer. Yes, I do believe there will be enough engineers and tradesmen trained in ‘‘green collar jobs’’ to support the ambitious goals I have announced within the Department of the Navy. Our Navy engineers and architects have years of experience incorporating sustainable principles such as the Leadership in Energy and En- vironmental Design (LEED) Green Building Rating System. As this new economy emerges, the Department of Labor is providing over $500 million in grants, as part of the American Recovery and Reinvestment Act initiative, to fund workforce development projects that promote economic growth by preparing workers for careers in the energy efficiency and renewable energy industries. Additionally at the Depart- ment of Veterans Affairs, a new program called Veterans Green Jobs (VGJ) is teaching returning veterans to become leaders in creating a more secure and sustainable future for the United States. All across the United States universities, community colleges, and vocational technical institutions, are developing curriculum to address this new and exciting field. This emphasis on Green Collar Jobs is being embraced in both the public and private sector. Businesses see an improvement in their bottom line, through energy cost savings and by going green, which causes a ripple effect throughout the supply system. By working together, and with the Department of the Navy taking the lead, the United States will move away from dependence on fossil fuels and move toward a more secure energy future. Question. Secretary Mabus, last year the Congress approved multi-year procurement authority for the F/A–18 aircraft. What is Navy doing to follow up on that course of action? Answer. The Navy is actively working with the prime contractor and OSD to determine if sufficient savings are available through a multi-year acquisition contract. As described in the February 26, 2010, letter from Deputy Secretary of Defense to the committees, within the last few months, the Department’s procurement profile for the F/A–18 increased by 35 aircraft and extended the final year of procurement from 2012 to 2013. The prime contractor provided a viable offer committing to a multi-year procurement on February 22, 2010. The Director, Cost Analysis and Program Evaluation (CAPE), is currently conducting a cost analysis of the potential savings of a multi-year versus single year procurement, as required by statute. If sufficient savings are identified, the Secretary of the Defense will certify to Con- gress the amount of savings and notify Congress of its intent to enter into a multi- year procurement (MYP). In addition, Navy is working with the committee staffs for legislative relief to fiscal year 2010 MYP language in National Defense Authoriza- tion Act and Defense Appropriations Bills.

QUESTION SUBMITTED BY SENATOR THAD COCHRAN Question. Secretary Mabus, there has been some advocacy for additional funding outside the normal shipbuilding budget to fund a new ballistic missile submarine fleet. If the Navy does not receive additional funding for the project in the coming years, do you foresee the $80 billion or more cost of the program forcing big shipbuilding cuts and triggering industry consolidations? Answer. Recapitalizing the SSBN force with funding from the SCN core budget will impact the Navy shipbuilding programs (fiscal year 2019-fiscal year 2033). In total, the Department of the Navy’s annual SCN and NDSF budgets average approximately $15.9 billion per year (fiscal year 2010 dollars) throughout the period of the fiscal year 2011 Annual Long-Range Plan for Construction of Naval Vessels. Because of the expected costs for these important national assets, annual SCN budgets during the mid-term planning period (fiscal year 2021-fiscal year 2030) will average about $17.9 billion (fiscal year 2010 dollars) per year, or about $2 billion more than the steady-state 30-year average. Even at this funding level, the total number of ships built per year will inevitably fall because of the percentage of the shipbuilding account which must be allocated for the procurement of the SSBN. As a result of the limited shipbuilding and the rapid retirement of ships built in the 1980s, after peaking at 320 ships in fiscal year 2024, the overall size of the battle force is forecast to gradually fall, reaching 288 ships in fiscal year 2032. In the far-term planning period (fiscal year 2031-fiscal year 2040), average SCN budgets return to about $15.3 billion (fiscal year 2010 dollars) average per year. After the final order for Ohio class replacement in fiscal year 2033, the average inventory per year begins to rebound from a low of 288 ships in fiscal year 2032 to 301 ships in fiscal year 2040. 230

The need to fund SSBN recapitalization will result in some risk to the Navy’s shipbuilding plan. Given the expected challenges of the mid and far term periods, significant consideration must be given to ascertain the way ahead for the Navy. DON will have to consider operational demands that could change force structure requirements as well as inherent technology requirements of future platforms and the effect they have on platform cost. Additionally, we will need to complete an analysis of force structure requirements over the next decade as we get a better understanding of what threats and obstacles lie in front of us to determine what the complexion of the 2040 force ought to look like and the efficacy of the planned force in meeting those challenges. The Navy recognizes that stabilizing ship procurement to help sustain minimum employment levels and skill retention promotes a healthy U.S. shipbuilding industrial base. The Navy also recognizes that building the required force structure will largely depend on controlling shipbuilding costs (including combat systems) within an affordable range. The Navy is committed to maintaining stability in requirements, funding and profiles in an effort to control costs. This will require the combined efforts of the Navy and the shipbuilding and combat systems industries. Working in conjunction with Congress, the Navy will procure and sustain the force structure necessary to deliver the capabilities required of United States naval forces.

QUESTIONS SUBMITTED TO ADMIRAL GARY ROUGHEAD

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE Question. Admiral Roughead, in December, the Congressional Research Service reported that the Department of the Navy will have a shortfall of 243 strike fighters in 2018. The Navy today is projecting a shortfall of about 100 aircraft toward the end of the decade. That 100-aircraft shortfall assessment was made prior to the recent grounding of 104 F/A–18s due to structural cracks. Could you address the steps that the Navy is taking to reduce the shortfall and the risks associated with that plan? Answer. The Navy is today projecting a shortfall of about 100 strike fighters in the 2018 timeframe. Anticipating a shortfall, the DON continues to identify further opportunities to reduce its impact. The strike fighter shortfall can be mitigated through the application of the near and long term management actions. Examples are—the Marine Corps modifying it’s F–35 transition plan by transitioning some Hornet squadrons earlier and leveraging the service life remaining in the AV–8B fleet, the Navy accelerating the transition of five legacy F/A–18C squadrons to F/ A–18 E/F and transitioning two additional F/A–18C squadrons to F/A–18E/F using the remaining attrition F/A–18E/F reserve aircraft, and reducing the Navy Unit De- ployment Program (UDP) and USMC Expeditionary F/A–18A∂/C/D squadrons from 12 to 10 aircraft per squadron. Although global demand may challenge implementation of some of these actions in the near term, changes in the operational environment in the future may allow additional flexibility in their implementation. As we go forward, we are considering all options to manage our inventory and balance risk, including SLEP to some number of F/A–18 (A–D) aircraft to extend their service life to 10,000 flight hours and optimizing depot efficiencies. SLEP analysis continues and will be addressed in the fiscal year 12 budget process. The Department of the Navy continues to rigorously manage the service life and warfighting effectiveness of each of our legacy Hornets, Harriers, and Super Hornets to ensure the maximum contribution to the nation’s security for the taxpayer dollars invested. Question. This year, the Navy began a major development effort on a new ballistic missile submarine to replace the aging Ohio-class. Nearly $6 billion is committed to designing the submarine over the next 5 years, and the cost of each submarine is expected to be $7 billion. Admiral Roughead, the Navy is working with Strategic Command to refine key decisions about SSBN–X. What have we learned about the needed capabilities of the submarine as a result of those reviews? Answer. The Ohio replacement will be a strategic, national asset whose endurance and stealth will enable the Navy and Nation to provide continuous, survivable strategic deterrence into the 2080s. Our Initial Capabilities Document (ICD) for our Ohio replacement identified several key attributes the submarine must have, including improved stealth, survivability, reliability, endurance, tailorability, and adapt- ability. To ensure there is no gap in our future strategic deterrent capability, the design process for the Ohio replacement started in fiscal year 2010 to ensure suffi- 231 ciently developed technologies and a mature design are in place to support lead ship authorization in fiscal year 2019. Question. Admiral Roughead, the Navy has historically assumed some risk in ship depot maintenance, while balancing resources and requirements across the Depart- ment’s readiness portfolio. For the past 8 years, the Navy has requested an average of 96 percent of the projected ship depot maintenance costs in any given year. How- ever, in fiscal year 2011, the request level has jumped to 99 percent. Considering the limited resources available in all readiness accounts, please explain the Navy’s decision to make ship depot maintenance a priority in fiscal year 2011, and whether the Navy will continue to fund it at the higher level in the future. Answer. Continued investment in depot level maintenance is essential in achieving and sustaining the force structure required to meet our global security interests. Our ships are capital assets that operate in challenging physical and security environments. Almost three-quarters of our current Fleet will still be in service in 2020. As a result of increased technical assessment, we have raised the priority of ship’s depot maintenance, keeping the Fleet in satisfactory operating condition to preserve our ability to accomplish assigned missions and for the ships and aircraft to reach expected service lives. In May 2009, Navy established the Surface Ship Life Cycle Maintenance (SSLCM) Activity to provide timely depot-level maintenance determined by an engineered assessment of expected material durability and scoped by actual, not estimated, physical condition. The SSLCM Activity’s engineering assessments of maintenance requirements for DDG 51 and LSD 41/49 provided the technical foundation for our decision to increase maintenance funding in our fiscal year 2011 budget request. The SSLCM Activity is in the process of completing engineering assessment of maintenance requirements for the remainder of surface ship classes in the near term. Question. Admiral Roughead, what kind of actions is the Navy undertaking to reduce the reliance on supplemental funding for ship and aircraft depot maintenance? Answer. The Navy is currently engaged with the Office of the Secretary of De- fense, Cost Assessment and Program Evaluation (OSD CAPE) to assess Navy’s base and overseas contingency operations (OCO) funding needs as they relate to future requirements. Findings from this effort will serve as the basis for establishing a more refined apportionment between baseline and OCO funding requests for ship and aircraft depot maintenance. Question. Admiral Roughead, as you know, the Subcommittee has supported the Navy’s decision to end procurement of the DDG 1000 program and restart the DDG 51 program. I understand that in addition to restarting the DDG 51 program, the Navy now proposes to terminate the next generation cruiser in order to build an improved version of the DDG 51, the so-called Flight III. Could you give us an update on the status of the DDG 51 restart, explain why building an improved version of the DDG 51 is an adequate substitute for the cruiser, and why it is the right ship for the fleet in the future? Answer. We are well underway with restarting DDG 51 production and the restart is on schedule and on budget. A total of nine DDG 51 restart hulls will be procured from fiscal year 2010 through fiscal year 2015, alternating between one per year and two per year beginning in fiscal year 2010. Our fiscal year 2011 budget requests funding for the construction of two ships: DDG 114 and 115. We are also in the process of conducting a full and open competition for the Main Reduction Gears (MRG) to be installed on DDG 113 and follow on ships. Source selection is in progress, and the contract award is projected for Spring 2010. The MRGs are being procured using a firm, fixed-price contract and will be provided to the shipbuilders as Government Furnished Equipment. Our DDG 51 restart ships (Flight IIA) will be the first constructed with Inte- grated Air and Missile Defense (IAMD), providing much-needed Ballistic Missile De- fense (BMD) capacity to the Fleet, and they will incorporate the hull, mechanical, and electrical alterations associated with our mature DDG modernization program. We will spiral DDG 51 production to incorporate future IAMD capabilities. In consultation with the Office of the Secretary of Defense, Navy conducted a Radar/Hull Study for future surface combatants that analyzed the total ship system solution necessary to meet our IAMD requirements while balancing affordability and capacity in our surface Fleet. The study concluded that the most cost-effective, total-ship solution to Fleet air and missile defense requirements over the near- to mid-term is a DDG 51 hull with a new Air and Missile Defense Radar (AMDR), coupled to the Aegis Advanced Capability Build (ACB) combat system. This combination of ship, sensor, and combat system will provide our Fleet with the capabilities needed for future mission success with less risk and cost than a new start cruiser 232 program. The first of these ships, designated as DDG 51 Flight IIIs, will be procured in fiscal year 2016. Question. Admiral Roughead, what are the potential operational impacts to the fleet of building improved DDG 51’s instead of the next-generation cruiser? Answer. Restart of the DDG 51 class, and the spiraling of air and missile defense capabilities into the DDG 51 Flight III, will deliver required Integrated Air and Mis- sile Defense (IAMD) capability and capacity into the Fleet sooner, at a more affordable cost, and with less risk than pursuing a new start cruiser program at this time.

QUESTIONS SUBMITTED BY SENATOR THAD COCHRAN Question. Admiral Roughead, the Navy has cancelled plans to replace EP–3 airborne reconnaissance aircraft. This decision raises the question about the replacement strategy for the Navy’s Special Projects Aircraft. How long does the Navy intend to maintain and operate the EP–3 and Special Projects Aircraft, and considering the work these aircraft do, have you considered continued investment to improve the capabilities of these aircraft until a replacement airframe is selected? Answer. Navy continues to sustain the operations and maintenance of our EP– 3 and Special Project Aircraft. We are evaluating several options for our future airborne SIGINT capability, including accelerating the Initial Operating Capability (IOC) of the Broad Area Maritime Surveillance (BAMS) Spiral 3, which is SIGINT- equipped; equipping a Medium Range Ship-Based UAV with SIGINT payloads with an IOC in about 2016–2017; and outfitting a modest number of manned platforms initially with remote SIGINT sensors. Question. Admiral Roughead, the Navy is beginning design work on a new submarine to replace the aging Ohio-class ballistic missile submarine fleet. The cost estimate to design and build 12 submarines under this program is staggering, $80 billion or more. This creates a concern as to whether the Navy can afford these new submarines without curtailing or giving up other shipbuilding efforts. Under the current shipbuilding plan and funding profile, what is your assessment of the impact this costly program will have on the industrial base and overall ship force structure level? Answer. The battle force inventory presented in our 30-year shipbuilding plan provides the global reach, persistent presence, and strategic, operational, and tactical effects required of our naval forces within reasonable levels of funding. On balance, the force structure represented by our 30-year shipbuilding plan maintains our ability to project power across the spectrum of challenges we are likely to face throughout the time period of the report, albeit with prudent risk where appropriate. One of the plan’s three basic precepts is the importance of maintaining an adequate national shipbuilding design and industrial base necessary to build and sustain tomorrow’s Navy. The shipbuilding plan aims to maintain that base. The SSBN(X) procurement will begin to constrain our shipbuilding plan in the latter part of this decade because recapitalization of our SSBNs will occur at the same time our SSN 688 submarines, CG 47 class guided missile cruisers, DDG 51 class guided missile destroyers, and LSD 41/49 class dock landing ships reach end-of-service-life. During the years in which the new submarine is being procured, the procurement of other ship types will be reduced, resulting in force level and industrial base impacts. Even under these constraints, our shipbuilding plan still achieves a peak battle force inventory of 320 ships in fiscal year 2024 and averages about 303 ships between fiscal year 2020 and fiscal year 2040.

QUESTIONS SUBMITTED TO GENERAL JAMES T. CONWAY

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE Question. General Conway, in December 2009, a key deadline passed without a decision by the Japanese Government regarding the realignment of U.S. forces on Japan and the movement of Marines to Guam. This move includes the closure of Futenma and the expanded land return to the people of Okinawa. The Government of Japan is now saying they will have a decision in May, but some are concerned that this decision may be delayed until after the July election. Can you please share with us the impact of further delays in a decision on the future force structure and the overall political relationship between Japan and the United States? Answer. It would be imprudent to alter the force laydown, to include moving any forces to Guam, until the Futenma issue is adequately resolved. The realignments of U.S. forces on Japan and the relocation to Guam are capabilities issues, not basing issues, and we have a responsibility to provide ready and able forces in support 233 of the Combatant Commander. We need to look at future force laydown in the Pa- cific in total, and central to this are aviation capabilities on Okinawa. The Marine Corps requires that an aviation capability must remain on Okinawa to support the rest of the Marine Air Ground Task Force there. We currently have that capability at Futenma. If a replacement facility were delayed, untenable or un- resolved for whatever reason, we would maintain our current force structure and continue to operate out of Futenma. In the context of the overall political relationship, we understand that the U.S.- Japan negotiated agreements were a comprehensive set of realignment initiatives designed to meet the strategic needs for both allies. We understand that the Govern- ment of Japan is taking a hard look at options however, we are confident that they realize the strategic value of having Marines on Okinawa for their own defense and for security in the region. Question. General Conway, please lay out the current plan to realign 8,000 Ma- rines and their dependents to Guam. What are your biggest concerns with the plans? Answer. Based on the Agreed Implementation Plan, the units relocating to Guam will be the headquarters elements of the III Marine Expeditionary Force, including 1st Marine Air Wing, 3rd Marine Division, and 3rd Marine Logistics Group. With a move of this size and scope, there are inherent concerns. We must ensure that our distribution of forces in the Pacific will provide an enduring USMC presence in the region with ready and able forces, while ensuring the quality of life for our Marines and their families. We must balance our commitment to Japan to reduce our force structure in Oki- nawa, while ensuring that our force laydown in the Pacific remains responsive to the Nation’s and the combatant commander’s needs. A balanced Marine Air-Ground Task Force capability in the Pacific—on Okinawa, on Guam, and on Hawaii—is an essential ingredient in our ongoing analysis. We must ensure we have the right force laydown. Through the Quadrennial De- fense Review, the Marine Corps analyzed refinements to the AIP that enhance operational capabilities. The AIP laydown was based on a 2006 force structure that had approximately 28,000 Marines and Sailors assigned to III MEF. Since 2006 the Ma- rine Corps has been authorized to grow to 202,000 Marines With todays force structure, that number would be closer to 31,000. On Okinawa, the corresponding units under the AIP would account for nearly 11,000 Marines, exceeding the personnel strength provided for in the current agreement. We are examining alternatives that remain within the 10,000 Marine cap on Okinawa. Question. The Expeditionary Fighting Vehicle has been in development for more than a decade, and many questions have been asked about its ability to protect Ma- rines from roadside bombs. If the program can overcome its development challenges, it has been proposed that after the EFV travels from the sea to take a beach, additional armor could be then be added to afford greater protection to its crew before they continue inland. General Conway, what is your response to those who might question this strategy as having to manage the tradeoffs of speed in amphibious operations against the protection of Marines? Answer. Each of the Services is organized differently to achieve different missions. The Navy, Army, and Air Force are organized to dominate their respective domains (sea, land, and air) while the Marine Corps—a rapid-response, general-purpose air- ground task force—operates across all domains. In the case of the Expeditionary Fighting Vehicle (EFV) and amphibious operations, a balance of speed and force protection is essential during movement from ship to shore, and subsequent movement on land. The increased range, speed, mobility, and firepower of the EFV generates a high degree of force protection and allows our forces to maintain the initiative while keeping the enemy off balance. If the situation becomes static, like in Iraq or Afghanistan, the application of modular armor for the EFV would offer greater force protection for our troops against the most likely threat. There would likely be some trade-off under that configuration with regards to speed and mobility—but the added protection brings the vehicle to MRAP-like survivability. Moreover, our lessons learned over the past several years have shown us speed is not necessarily a plus where the enemy can plot—then lay Improvised Explosive Devices against—movement patterns. In summary, we are committed to providing our Marines the best vehicle possible to meet all mission requirements while providing the greatest levels of force protection. We will do all that while acting as responsible stewards of the nation’s precious resources. 234

QUESTIONS SUBMITTED BY SENATOR THAD COCHRAN Question. General Conway, when requirements for amphibious ships are determined and validated, is consideration given to the demand signal from geographic Combatant Commanders for amphibious ship capabilities and support. If so, could you share with the subcommittee what the aggregate demand from Combatant Commanders is for amphibious ships? Answer. The Department took into consideration what had been historically sourced in order to meet Combatant Commanders (CCDRs) missions when the CNO and CMC developed the requirement for amphibious ships. However, the primary driver for the Navy’s requirement was Marine Expeditionary Brigade (MEB) Assault Echelon lift, and 38 ships fiscally constrained to 33 ship force that supports a 2.0 MEB lift. Assessment of CCDR steady state demand and demand registered in the Global Force Management and Joint Capabilities Requirements Manager since fiscal year 2008 requires not less than an inventory of 50 amphibious ships to meet the stated needs of the CCDRs. Aggregate CCDR demand for amphibious ships in fiscal year 2010 was for 4.3 ARG/MEUs and 3.8 independently deploying amphibious ships. Sourcing that demand, using OPNAV rotation rates, would require a force structure of 58 ships. Question. General Conway, based on current major contingency plans what is the requirement for amphibious ships, and how can these plans be conducted with the current number of amphibious ships? What is your personal opinion concerning the amount of risk being accepted in maintaining only 29 to 31 amphibious ships to support warfighting plans for which the Marine Corps has been tasked to be prepared? Answer. The requirement for 38 amphibious ships to conduct 2.0 MEB forcible entry operations has been fully analyzed and agreed to, in writing, within the De- partment of the Navy. Given the fiscal constraints facing the Department of the Navy, the Secretary of the Navy, Chief of Naval Operations, and I agreed that 33 amphibious ships in the assault echelon represents the limit of acceptable risk in meeting the 38-ship requirement we established in a letter to your committee on January 7, 2009. This 33-ship force accepts risk in the arrival of combat and combat service support elements of the MEB, and represents a trade off to preserve the Sea Shield. The 29–31 ship inventories during the future years defense plan (FYDP) does present risk in our Nation’s ability to overcome anti-access challenges in locations along the ‘‘arc of instability,’’ where there are no American military forces or basing agreements. Moreover, with the current inventory of 31 amphibious ships, we are unable to meet all of the steady state combatant commander demands for theater security cooperation, forward presence, and crisis response. The Long-Range Plan for Naval Vessels projects an effort to build toward the 38 amphibious ship requirement. However, the closest the plan comes to achieving the requirement is 36 amphibious ships in fiscal year 2026.

SUBCOMMITTEE RECESS Chairman INOUYE. This subcommittee will stand in recess until March 24—Wednesday—at which time we will receive testimony from the National Guard and Reserves. The subcommittee is in recess. [Whereupon, at 11:35 a.m., Wednesday, March 17, the subcommittee was recessed, to reconvene subject to the call of the Chair.] DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, MARCH 24, 2010

U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10:05 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) presiding. Present: Senators Inouye, Leahy, Murray, Cochran, Bond, and Brownback. DEPARTMENT OF DEFENSE

NATIONAL GUARD STATEMENT OF GENERAL CRAIG R. McKINLEY, CHIEF, NATIONAL GUARD BUREAU ACCOMPANIED BY: MAJOR GENERAL RAYMOND W. CARPENTER, ACTING DIRECTOR, ARMY NATIONAL GUARD LIEUTENANT GENERAL HARRY M. WYATT III, DIRECTOR, AIR NA- TIONAL GUARD

OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. This morning, the subcommittee meets to receive testimony on the fiscal year 2011 budget of the National Guard and the Reserve components. And from the National Guard, we are pleased to have the Chief of the National Guard Bureau, General Craig McKinley; the Direc- tor of the Army National Guard, General Raymond Carpenter, who is testifying with us for the first time; and the Director of the Air National Guard, General Harry Wyatt. And from the Reserves, we welcome the Chief of the Army Re- serve, General Jack Stultz; the Chief of the Naval Reserve, Admi- ral Dirk Debbink; the Commander of the Marine Corps Reserve, General John Kelly, who is also appearing before this subcommittee for the first time; and the Chief of the Air Force Re- serve, General Charles Stenner. And I thank all of you for joining us today, and the subcommittee reviews fiscal year 2011 budget. Over the last several years, the Guard and Reserves have made important changes as they transition from a strategic to an operational reserve. The Department has improved its resourcing of the Guard and Reserve, and the services have made significant strides (235) 236 in integrating the Reserve components in an effort to create one total force. The Guard and Reserve have also recovered from the recruiting and retention difficulties they confronted over the last several years. Although retaining personnel in certain high-demand career fields remain a challenge, the significant personnel shortages seen in years ago have been eliminated, and the Reserve components now have the opportunity to focus on refining their personnel mix to get the right person in the right position. And I wish to congratulate all of you. However, many challenges remain. The Guard and Reserve must continue to improve reintegration and family support programs. Suicide, divorce, and substance abuse are on the rise in the military, and the Reserve components are no exception. Reservists and their families lack the support network provided at Active Duty installations, so it is essential that we do everything we can to support Reserve families during deployments and as the reservists transition back to civilian life. Your Yellow Ribbon Program is a step in the right direction, but I encourage you to continue improving the program to better fit the needs of our servicemembers. And I look forward to hearing, today, what each component is doing to improve support to our Reserve families. The Guard and Reserves still face significant equipment shortfalls. For this reason, last year Congress provided $950 million for the National Guard and Reserve equipment account to allow the Reserve components to purchase the additional equipment they need for predeployment training and operations at home and abroad. Congress has provided additional equipment funding for the Guard and Reserve in each of the last 30 years, because, year after year, the President’s budget fails to sufficiently fund the Re- serve components. Some critics decry the additional funds by this subcommittee as unnecessary earmarks, but I’m certain that the witnesses here today agree that, without this additional funding, our Reserve components would be woefully equipped. The success of the Guard and Reserve depends on the support of Reserve employers. The weak economy is placing additional strain on the employers, who must fill the jobs left by reservists when they deploy. As many reservists face their second, or even third, deployment, we must ask whether the current operational tempo is sustainable and what more we can do to ensure that we maintain the support of our business community in hiring and supporting Reserves. So, gentlemen, I look forward to the hearing, to hearing your perspective on these issues, and working with you this year in support of our guardsmen and reservists. And I thank you for your testimony this morning. And may I say that your full statements will be made part of the record. We’ll begin our hearings with the panel from the National Guard, but first I’ll turn it over to my vice chairman, Senator Coch- ran, for an opening remark he may wish to make. 237

STATEMENT OF SENATOR THAD COCHRAN Senator COCHRAN. Mr. Chairman, thank you very much. I’m pleased to join you in welcoming this distinguished panel of witnesses before our subcommittee. And we look forward to working with them to identify ways we can make sure that the Guard and Reserve programs are funded at appropriate levels, and that they’re able to carry out their duties and responsibilities under the law. Very important role. Gets more important as time has gone on. And Guard and Reserve personnel and leadership are depended on more and more to help protect the security interests of our great country. Chairman INOUYE. Senator Bond, would you care to make your remarks? STATEMENT OF SENATOR CHRISTOPHER S. BOND Senator BOND. Thank you very much, Mr. Chairman. And I join with you and the ranking member, Senator Cochran, in welcoming the leadership of the National Guard today. And on behalf of the National Guard Caucus, Senator Leahy and I thank you for this tremendous support you’ve provided the Guard over the years. As you have indicated, had the subcommittee simply rubber- stamped the budget proposed over the last few decades, the Na- tional Guard today would be a hollow force, if it were still a force. Instead, this subcommittee and the Congress, as a whole, have chosen, many times, to make up the shortfall in equipment budgets and manpower so that the Guard could continue to perform its missions. By investing in the Guard, we serve the national security interests of the country, ensure the protection of the homeland, at a fraction of the cost of the Active Duty, leveraging the incredible skills and experience of our citizen-soldiers and airmen. I will ask that—submit for the record a letter that Senator Leahy and I have prepared on behalf of the National Guard Caucus, asking the Secretary of the Air Force to reconsider the decision made with respect to the C–130 aircraft and they made—a decision made without consultation with the Guard. And I thank you very much. Chairman INOUYE. Without objection, so ordered. Senator BOND. Thank you, sir. [The information follows:] UNITED STATES SENATE, Washington, DC, March 24, 2010. The Honorable MICHAEL B. DONLEY, Secretary of the Air Force, Washington, DC 20330–1670. DEAR SECRETARY DONLEY: On behalf of the 96 member strong Senate National Guard Caucus, we are concerned and oppose the force structure cuts to the Air Na- tional Guard C–130 fleet. We are seriously troubled that the Air Force would consider taking aircraft from the Air National Guard to fill gaps in the Active Compo- nent. This most recent announcement is a troubling move in what appears to be a consistent trend since the 2005 BRAC to reduce the number of aircraft from the Air National Guard without substantive or even any consultation with Air National Guard leadership. The most disconcerting cuts come from the drawdown based on the Mobility Capa- bilities and Requirements Study 2016 (MCRS 16), which at the time of budget decisions, was still being developed. The programmatic decision resulting in these cuts 238 was based from a draft study which now reflects what the budget had already announced. In a time of economic downturn and smaller defense budgets, we encourage the Department of Defense and the Air Force to adopt structures such as active associate wings to leverage the Air National Guard’s lower operating and infrastructure costs and more experienced civilian airmen. We urge you to reconsider the C–130 Force Structure changes and seriously review alternative courses of action that will preserve our mobility capability for both of the Air National Guard’s Federal and State missions. Sincerely, SENATOR PATRICK LEAHY, Co-Chair, Senate National Guard Caucus. SENATOR CHRISTOPHER S. BOND, Co-Chair, Senate National Guard Caucus. Chairman INOUYE. This morning, we have two panels. The first panel consists of the Chief of the National Guard Bureau, the Di- rector of the Army National Guard, and the Director of the Air Na- tional Guard. So, I’ll call upon, first, General Craig McKinley. General McKinley. SUMMARY STATEMENT OF GENERAL CRAIG R. MC KINLEY General MCKINLEY. Chairman Inouye, Vice Chairman Cochran, Senator Bond, it’s an honor and privilege to be here today. I guess we won the coin toss, so the Guard goes first this year. We’ve kind of alternated the 4 years I’ve been here, so I think we’ll try not to run out the clock on the Reserve Chiefs, who are really strong colleagues of ours. We operate as seven very close representatives representing the Reserve component force and the National Guard, and it’s an honor to be here with you today. We’ve got about 460,000 members of the Army and the Air Na- tional Guard. And, as you said, Mr. Chairman, our strength is good, and our retention is even better. On my right, your left, is Bud Wyatt—Lieutenant General Bud Wyatt. Bud joined our team a year ago. He was former adjutant general in Oklahoma, so he knows not only the Federal piece of our business, but he has represented the State of Oklahoma exceedingly well. And on my left, your right, is Major General Ray Carpenter. Ray has been just a stalwart in standing in for the retirement of our former Director of the Army National Guard, Lieutenant General Clyde Vaughn. And, for almost a year now, Ray has managed the day-to-day operation of the Army Guard, working with United States Army. So, it’s a pleasure for me to be ably assisted by these two fine gentlemen. The Department, for your interest, sir, is moving forward to identify a nominee for the position of the Director of the Army National Guard. It’s a critical billet, and we have had the board—names have been recommended to both General Casey and Secretary McHugh. And so, they will be considering that. We hope, obviously, that that name gets over here and we move to confirm as quickly as possible. Senator Leahy, how are you, sir? We’ve submitted a copy of our posture statement to the subcommittee, and offer that as our formal testimony for the record. General Wyatt and General Carpenter will speak, in detail, about 239 the budget request for the Army and the Air National Guard, as they work with our parent services in the budget process. As United States Armed Forces continue to conduct operations in Iraq, Afghanistan, and elsewhere around the world, units of the Army and Air National Guard are participating as total force partners in that effort. The National Guard has repeatedly proven itself to be a ready, accessible force. We have validated the total force concept by showing that the men and women in our formations are ready to answer the call, to be mobilized, to deploy overseas, return home, and then become prepared to do it again and again. The citizen-soldiers and airmen of your National Guard are adding value to America every day that they serve. The capabilities they bring to bear would not have been possible without the strong support of this subcommittee, and we thank you all very much for that support. The most critical part of that proven capability, however, is our National Guard men and women. Today’s men and women volunteer to join, or stay, in the National Guard fully expecting to be deployed. This shift in expectation is a central aspect of the National Guard shift to being a fully operational force and no longer merely a strategic Reserve. Indeed, the soldiers and airmen of your Na- tional Guard now serve with that expectation, and are proud of it. They want to remain central players in the Nation’s defense, and would indeed be resistant to any move to return to a role limited to strictly strategic Reserve. Overall, we can say that the budget request for fiscal year 2011 meets the critical needs of the Army and Air National Guard in this era of persistent conflict overseas and ongoing threats to American lives and property here in the homeland. Of particular importance to us is the request for operations and maintenance funds. This money is critical. We use it to buy the fuel, the spare parts, building maintenance, and other things essential to being effective Reserve components of the Army and the Air Force, and we ask the subcommittee to fully fund that request. All of us in the National Guard are highly mindful and deeply grateful for the strong support of the National Guard which this subcommittee has shown to us in the past. In return, we try to be good stewards of the funds you appropriate for us, and use that money to make your National Guard as strong as it can be. We’re particularly grateful for the additional funds which this subcommittee has provided through the National Guard and Reserve equipment account. We have used those funds to fill critical shortages in the Army National Guard and to provide technological modernization in our Air National Guard capabilities. We are especially grateful for the flexibility in which those funds are provided to us, allowing us to apply that money to our most critical equipment needs. And, as my predecessor Steve Blum was fond to say, ‘‘Every dollar that is funded through the National Guard and Reserve equipment account is spent in that area.’’ One of the longest-running joint programs in the National Guard, one which employs both Army and Air National Guard capabilities, is the National Guard Counterdrug Program. This unique program provides a mechanism under which National Guard military experience can be employed to assist civilian law 240 enforcement agencies to fight the corrosive effect of illegal drugs in American society. Funding for this program is included in the fiscal year 2011 budget request, and we ask for your full support of that request. As we’ve seen, parenthetically, with recent incidents along our Southwest border, the scourge of drugs migrating across that border creates a lot more concern on our part that this program still fills a very vital need. We are well aware that last year, as it has done in previous years, this subcommittee provided significant additional funds for that counterdrug program to fund capability enhancements. Nearly one-quarter of the capability of the National Guard Counterdrug Program exists today because of the additional funding provided in the past by Congress. In order to move quickly to your questions, I would now like to ask my Directors of the Air and Army National Guard to provide their perspectives. But, before I do that, I would just like to personally thank Senator Bond for his years of service to the Senate Guard Caucus. PREPARED STATEMENT We can’t thank you, sir, enough, and your staff, for being there, for listening to us, and for providing that great leadership. And we wish you a great deal of well-being back in the State of Missouri when this run is over. Thank you, Senator Bond. Bud? [The statement follows:]

PREPARED STATEMENT OF GENERAL CRAIG R. MCKINLEY

INTRODUCTION AND EXECUTIVE OVERVIEW About 400 years ago, a few hardy souls boarded tall ships from the shores of their comfortable European homeland to travel to a North American wilderness. They risked their lives on the treacherous waters of the North Atlantic for a new land and a better life. Immediately, homeland security became a concern for these early settlers. In times of need, volunteers from tiny hamlets and towns picked up their muskets to rush to the defense of their homes and families. Out of this necessity, the first militia was organized in the Massachusetts Bay Colony in 1636. About 140 years later, these Citizen-Soldiers had become a formidable force. At the Battle of Concord in 1775, outnumbered musket-wielding militia defeated an ‘‘invincible’’ British force and the enduring reality of the Minuteman was born. The Minuteman image was immortalized in the statue that stands today by the North Bridge, which spans the Concord River. The Minuteman was sculpted in traditional militia mufti with one hand on the plow and the other grasping a musket. The Citizen is ready at a moment’s notice to become the Soldier. That ethos continues, ever stronger today, abroad and at home. Our Citizen-Sol- diers and Airmen are adding value to America.

RAPID EVOLUTION The National Guard Abroad The depth provided by the National Guard is no longer the ‘‘once in a lifetime’’ use of a strategic reserve as envisioned during the Cold War. The National Guard has become an operational force that is an integral part of the Army and Air Force. It is populated by seasoned veterans with multiple deployments in support of operations in Iraq, Afghanistan, the Balkans, and many other locations around the world. 241

Our most precious assets flow from our communities. At this time, nearly 60,000 Citizen-Soldiers and Airmen are deployed in support of overseas operations in Iraq, Afghanistan, the Balkans, and the Sinai. The National Guard has maintained a high operational tempo for more than 8 years in support of the operations in Iraq and Afghanistan. Through the admirable service of thousands of Guardsmen we have provided essential combat, logistics, and other support capabilities to these operations. Most recently, the National Guard provided critical Humanitarian Relief and Dis- aster Response support following the massive earthquake of January 2010 in Haiti. From providing initial medical evacuation to sustained logistics support and airborne communications, National Guard Soldiers and Airmen quickly delivered the specialized expertise required to support the Haitian people in their hour of need. The National Guard at Home In addition to the thousands of National Guard Soldiers and Airmen currently activated for ongoing Federal missions overseas, the National Guard provides significant response to unexpected contingencies at home. On average, on any given day, 17 U.S. Governors call out their National Guard to help citizens in need. We responded in 2009 as we always have—immediately, effectively, appropriately, and in force. There’s no reason to believe 2010 will be any different. Three significant events in 2009 were the record floods in North Dakota, the incredibly devastating ice storms in Kentucky, and the aid Hawaii quickly delivered to American Samoa after a tsunami smashed into the island. Rapid and full emergency response is another service that our Citizen-Soldiers and Airmen do well. At the peak of flood fighting efforts, the North Dakota Guard responded with more than 2,400 Citizen-Soldiers and Airmen aided by Guardsmen from six other states including Minnesota, Wisconsin, South Dakota, Montana, Missouri, and Iowa. The Guard assisted with levee patrols, evacuating residents, and sandbag operations. Our Soldiers and Airmen also provided traffic control points and presence patrols. They flew aviation support missions, including reconnaissance and ice salt- ing to promote melting. They also delivered and operated water pumps, broke up ice jams, and performed other missions as required. In Kentucky, the entire Kentucky Army National Guard plus Guardsmen from Florida, Indiana, Ohio, Tennessee, and Wisconsin were called to duty, removing debris and running communications sites in addition to delivering essential supplies. Restoration of electric power to water plants, communications facilities, home generator support, operation of shelters in 24 armories, and removing downed trees were the top priorities. Troops worked with state and local crews clearing roads and gaining access to damaged power transmission lines. Our National Guard men and women delivered more than 285,000 meals and a half million bottles of water every day to needy communities. An 8.4 magnitude earthquake struck the Samoa Islands region on September 29, which resulted in a destructive tsunami with 15–20 foot waves impacting the east side of American Samoa. Buildings suffered damage; up to 6,000 people were without power; there were 1,912 refuges in 14 shelters; and 32 confirmed fatalities. Within 24 hours, about 90 National Guard personnel from Hawaii’s Civil Support Team and CBRNE Enhanced Response Force Package, a command and control element, and a mortuary affairs team flew to American Samoa to help in the recovery efforts. The National Guard is located in more than 3,300 communities around the nation providing an indispensable link between the military and the citizens of our great nation. We may be the only military that some of our citizens ever see. At the same time, more than 4,600 personnel are on duty in our daily ongoing domestic operations—state active duty, and Counterdrug and Air Sovereignty Alert missions. More than 390,000 are available to respond to any situation.

READINESS Personnel Despite all the nation has asked of them in the overseas warfight as well as here at home, we are recruiting and retaining National Guard members in impressive numbers and with higher quality marks. Americans join and stay in the National Guard. But as successful as we have been to date, we need continued support for recruiting and retention efforts. 242

Equipment The National Guard must have modern equipment if we are to remain successful as defenders of the homeland at home and abroad. Army National Guard (ARNG) units deployed overseas have the most up-to-date equipment available and are second to none. However, a significant amount of equipment is currently unavailable to the ARNG due to continuing rotational deployments and emerging modernization requirements. Many states have expressed concern about the resulting shortfalls of equipment for training as well as for domestic emergency response operations. The Army has programmed $20.9 billion for ARNG equipment for fiscal year 2009 through fiscal year 2013 to procure new equipment and modernize equipment currently on hand. We appreciate that support and also the strong interest of Congress and Department of Defense (DOD) in closing the gap between our domestic requirements and the available equipment in our armories and motor pools. The Air Force is in the midst of modernizing and recapitalizing its major weapons platforms, and the Air National Guard (ANG) must be concurrently and proportionally recapitalized, particularly in order to avoid the near to mid-term ‘‘age-out’’ of the majority of its fighter force. Our primary concern is that 80 percent of our F–16s, the backbone of our Air Sov- ereignty Alert force, will begin reaching the end of their service life in 7 years. To that end, we support the Air Force’s recapitalization plan, and believe that all roadmaps should be inclusive of the ANG as a hedge against this ‘‘age-out.’’ We shouldn’t be relegated to obsolete and incompatible equipment like we were during the Cold War. We have proven that the old way of doing business does not work in today’s environment. The National Guard must remain an operational force, indeed a strategic force, and must be resourced as such, so we can assist the Army and Air Force as much as possible. National Guard and Reserve Equipment Appropriation (NGREA) A significant success story over the past few years is how NGREA funding has helped the Guard fill equipment shortages. This is particularly true for shortages involving Critical Dual-Use (CDU) equipment, which are items that the Guard uses in both Federal and state missions. The equipment purchased through NGREA includes CDU, however no equipment is purchased solely for domestic use by the states. The use of NGREA has been instrumental in providing for the quality and quantity of ARNG equipment. It has also enabled the ANG to both support Over- seas Contingency Operations (OCO) and to also provide assistance to domestic response. An important benefit of NGREA funding is transparency in accounting. In fact, every dollar can be tracked and accounted for in the process. With NGREA, we are able to show Congress exactly what equipment the Guard received for the money spent and where that equipment is located. Training Along with preparations for Federal service, the National Guard prepares for possible use in domestic operations. To that end, in fiscal year 2009 the National Guard conducted four regional Vigilant Guard exercises and three combatant command/national level exercises to facilitate unity of effort. In fiscal year 2010, the NGB is building local, state, and national level exercise capability to support the 54 states, territories, and the District of Columbia in preparing for larger scale exercises, Na- tional Special Security Events (NSSE), and real world events. Agribusiness Development Teams Nowhere does today’s 21st century Minuteman embody the Citizen-Soldier promise better than in our Agribusiness Development Teams (ADTs) in Afghanistan, where it is so needed after 40 years of constant turmoil and war. We send Guardsmen, whose skills and livelihood are earned in agribusiness in the United States, to this war-torn country to help better their farming industry. The first team deployed from Missouri in 2007. Today, eight teams are dispersed throughout Afghanistan, doing incredible work promoting sustainable farming practices and stimulating Afghan agriculture. For the Guardsmen, that means engaging with local farmers and helping them address many of their challenges, such as water and infrastructure issues. Eighty percent of Afghanis depend on agriculture for their livelihood, so it’s incredibly important that if we’re going to attack all the challenges and ills that hinder Afghanistan, we help stabilize their agribusiness economy. 243

The goal is not to teach how to farm but to expand those skills that Afghan farmers already have. They know how to farm. They need someone to help them with the more scientific aspects of agriculture. Before those crops get to market they need to be harvested or processed. Texas and Missouri ADTs developed clean and sanitary meat processing facilities powered by renewable energy sources. Also, mechanical engineers in the Guard were able to teach the Afghans how to build wind turbines and help produce power for these facilities. In the end, that’s the goal—to find simple solutions to the challenges faced by Afghan farmers. Because of the ADTs, Afghanistan has entered into a bilateral relationship with Nebraska. There is a large Afghan population in Nebraska, and the University of Nebraska has a cultural center that has built a relationship that has endured for decades.

NGB AS A JOINT ACTIVITY In 2009, the National Guard made great progress in supporting DOD’s efforts to both manage the Reserve Components as an operational force and establish the Na- tional Guard Bureau as a joint activity. The NGB, as part of the total operational force, has a greater role and increased responsibility for shaping the discussion and recommendations within DOD for issues related to Homeland Defense and Defense Support to Civilian Authorities. The National Guard has always recognized its unique role as America’s first military responder. In the continued quest for serving our citizens, we have leveraged the concept of the Joint Staff, both at the national and at the state level, to ensure rapid, effective, coordinated responses to domestic emergencies. This capability is modular, scalable, and can maximize effectiveness by employing Army and Air Guard capabilities into a true joint response. This supports the Adjutants General with single procedures for communication, coordination, collaboration, and employment. State Partnership Program The National Guard State Partnership Program (SPP) establishes enduring and mutually beneficial partnerships between foreign countries and American states through the National Guard. This program is an important component of the De- fense Department’s security cooperation strategy, the geographic combatant commanders’ theater engagement programs, and U.S. Ambassadors’ Mission Strategic Plans. A primary aim is to promote partnership among the many nations working with us to advance security, stability, and prosperity around the globe. Today, American states are partnered with more than 60 foreign nations to focus on military-to-military, military-to-civilian, and civil security activities. Created in 1993, the SPP has helped the United States, European, African, South- ern, Pacific, and Central Commands engage the defense and military establishments of countries in every region of the globe. This valuable mutual security cooperation program will continue to expand in size and strategic importance. Interagency and Intergovernmental Coordination and Cooperation The National Guard’s dual mission requires a disciplined balance between persistent readiness to defeat threats to our nation and its vital interests, and constant availability to help our communities and states. To improve efficiency for all involved in domestic operations, the NGB is orchestrating an effort to maximize collaboration with partner organizations like the U.S. Coast Guard, U.S. Army Corps of Engineers, and the Federal Emergency Manage- ment Agency (FEMA). By working together with our partners, we will provide a more coordinated response for all catastrophes, natural or man-made.

FUTURE PLANS—OUR VISION The Guard must remain a community-based organization with a clear understanding of its dual role: to serve abroad in support of our national defense; and to serve the Governors and people of the states, territories, and the District of Co- lumbia to which they belong. Recognizing the principles of states’ rights and the tiered approach to domestic support to civil authorities, the Adjutants General (TAGs) will continue to provide a wide range of capabilities to their Governors and play a significant role in determining National Guard priorities and in shaping the future of the Guard. 244

In an era of persistent conflict, we need a predictable rotational model and we must maintain proficiency and interoperability with the rest of the force. We must modernize at a proportional rate to the Active Component. At a steady state, we are going to have persistent requirements. There are tough resourcing decisions ahead, but I am optimistic we will continue our relevancy both on the domestic front and abroad while continuing to take the very best care of our Airmen, Soldiers, and their families. What the future holds for the National Guard Bureau is to cement its cross-functional relationships with other government and military agencies to answer any call, anywhere with the utmost collaboration and effectiveness. This is how we will continue adding value to America long into the future. The following pages show how the Army and Air National Guard and the Joint Staff are doing their part to build a balanced, flexible, and cohesive force for the future.

MAJOR GENERAL RAYMOND W. CARPENTER, ACTING DIRECTOR, ARMY NATIONAL GUARD

MESSAGE FROM THE DIRECTOR Unique events, leadership transitions, and a change in vision defined another challenging and rewarding year for the Army National Guard (ARNG). The ARNG shifted its focus from quantity of assigned strength to quality of the force, a new vision for an experienced and accessible force. As a result, we have significantly increased the readiness of the Army National Guard. Our Soldiers are better trained and equipped to support overseas contingency operations and provide domestic support to our civilian authorities. The ARNG made notable progress with our Modular Force Conversion and Rebal- ance efforts. We have also implemented a number of innovative initiatives such as the: —Agribusiness Development Team; —Domestic All-Hazards Response Team (DART); —Muscatatuck Urban Training Center; —Battle Command Training Capability Program; —eXportable Combat Training Capability (XCTC); —Patriot Academy; —General Equivalency Diploma (GED) Plus; —Yellow Ribbon Reintegration Program; and —Community-Based Warrior Transition Program. Through these efforts, our Soldiers are educated, trained, equipped, and supported unlike any other time in our history. Our efforts to balance the lives of our operational units and individuals have given us the flexibility and effectiveness needed to keep America strong.

OPERATIONS Balancing domestic and overseas operations brings out the best in Army National Guard integrated missions. The concepts of ‘‘critical dual-use equipment’’ and ‘‘Cit- izen-Soldier’’ merge together to meet our international and domestic challenges. Building on our two pillars of strength—personnel readiness and equipment versatility—we conduct our integrated missions and accomplish our Soldier-centric goals. Overseas Contingency Operations (OCO) Overseas Contingency Operations have significantly increased the operating and deployment tempo within the Army National Guard. Nearly 60,000 Army and Air National Guard personnel are supporting expeditionary operations around the world, including Operations Enduring Freedom and Iraqi Freedom. Since 9/11, more than 316,000 Army National Guard Soldiers have been mobilized for Federal (Title 10) duty as of December 31, 2009, to support OCO around the world. Domestic Operations The Army National Guard coordinates and integrates policies, procedures, and capabilities to ensure critical operations continue in the event of an emergency, or threat of an emergency, anywhere in the United States and its territories. In January 2009, the ARNG supported Federal and state agencies during the most attended Presidential Inauguration in U.S. history by providing over 10,000 National Guard Soldiers from 14 states. The Soldiers supported civil authorities by providing traffic control points, reaction forces, and aviation support. The ARNG answered calls to their respective Governors for search and rescue, power generation, logistical support, debris clearing, sandbagging, security, law en- 245 forcement support, food distribution, and shelter construction during recovery efforts. Most notably, in March 2009 six states sent more than 5,500 Soldiers to support North Dakota during the Red River flooding. During this event, the ARNG provided 13 helicopters with crews to fill a mission assignment from the Federal Emer- gency Management Agency (FEMA). Domestic All-Hazards Response Team Initiated in fiscal year 2009, the Domestic All-Hazards Response Team (DART) formalizes the National Guard use of the ARNG Division Headquarters in response to all catastrophic events. When requested by the Adjutant General of an affected state, the DART response is coordinated through the Chief, National Guard Bureau. The Army National Guard has eight division headquarters. Three division headquarters serve as the DART Headquarters on an annual rotation—two divisions serving in the East and West and one reinforcing both regions. Approximately 50,000 troops are available east of the Mississippi and 30,000 west of the Mississippi for activation into Title 32 Status. The DART works within the existing Emergency Management Assistance Compact framework. The DART is also divided along FEMA Region boundaries and is well positioned for interagency response. The DART maximizes the modular structure of the 21st century Army and positions the nation to respond to any man-made or natural disaster (or to mobilize in preparation for such an occurrence). For more details on DART, please see the information paper at: www.ng.mil/features/ngps. ARNG Aviation Operational Support Airlift Agency (OSAA) The Operational Support Airlift Agency is a Department of the Army field operating agency under the National Guard Bureau that supports 114 aircraft worldwide and over 700 personnel. OSAA’s fleet of 80 fixed-wing aircraft represents the single largest fixed-wing organization in the Army today. Both at home and abroad in 2009, these aircraft: —Flew more than 56,000 hours; —Completed over 26,000 missions; —Transported nearly 20 million pounds of cargo; —Carried more than 100,000 passengers; and —Supported the U.S. Southern Command in Colombia, the Criminal Investigation Task Force, Office of Military Commissions, and United States Army South at Guantanamo Bay, Cuba. Combat Aviation Brigade (CAB) By virtue of its basing locations throughout the homeland, ARNG Aviation provides immediate responsiveness to the Governors. Additionally, with certain unique design and equipment differences, the aviation force is a critical component of De- fense Support to Civil Authorities. Six of the ARNG’s eight CABs have a unique security and support (S&S) Aviation Battalion whose primary mission is homeland support. Each S&S battalion is equipped with the new UH–72 light utility helicopter with communications and mission equipment packages that are optimized for coordination and interoperability with civilian police, fire, and emergency responders. In addition, the ARNG aviation force provides the Army with a NORTHCOM-dedicated Theater Aviation Brigade for the vital Chemical, Biological, Radiological, Nuclear, and High-yield Explosive (CBRNE) Consequence Management Force that will respond to any natural or man- made disaster in the homeland. The ARNG provides the total Army with 43 percent of its aviation force. For more details about the Combat Aviation Brigade, please see the information paper at: www.ng.mil/features/ngps. Light Utility Helicopter (LUH) Update The UH–72A ‘‘Lakota’’ Light Utility Helicopter is a state-of-the-art aircraft with twin engine reliability, a 21st century navigation/communication system, and a proven record of commercial aviation service. The Army developed the UH–72 Lakota to meet immediate and future light utility aviation needs. The ARNG now has 36 UH–72A aircraft and eight UH–72A MEDEVAC aircraft for a total of 44 Lakotas. The Army plans to field 12 UH–72As to the Army National Guard over the next several years with a total of 200 new UH–72s to be fielded to the National Guard by fiscal year 2017. For more details about the Light Utility Helicopter, please see the information paper at: www.ng.mil/features/ngps. 246

PRESENT AND FUTURE VALUE Modular Force Conversion and Rebalance By the end of fiscal year 2009, the ARNG completed the most comprehensive force structure change in its history. This 5-year effort saw more than 2,800 operating force units transform into modular designs while deploying 43,225 Soldiers to combat and support operations in Iraq, Afghanistan, and Kuwait. With this transformation, ARNG brigade combat teams are identical to Active Component Army brigades so they are compatible regardless of the mission. The ARNG continues to grow and adapt to fulfill all levels of the Federal and state missions in support of Homeland Security and Homeland Defense (HD), which includes supporting the warfighter. The historic fill rate for equipment for the ARNG has been about 70 percent. Fill rates declined to approximately 40 percent of equipment available to the Governors in 2006 due to cross-leveling equipment to support immediate deployment requirements. Seventy-seven percent of the ARNG’s Modified Table of Organization and Equipment (MTOE) requirement is currently on hand (as of the end of fiscal year 2009). Increasing our investment in several key areas is essential to maintaining our forward progress. Agribusiness Development Teams An Agribusiness Development Team (ADT) is a self-contained volunteer unit composed of 58 National Guard Soldiers with backgrounds and expertise in various sectors of the agribusiness field. They provide training and advice to Afghan universities, provincial ministries, and local farmers to increase stability and improve opportunities for Afghanistan’s reemerging agribusiness sector. Since 2007, Agri- business Development Teams from the following states have deployed to Afghani- stan: Missouri, Indiana, Tennessee, Kansas, Nebraska, Texas, California, Kentucky, Oklahoma, and South Carolina. For more details about ADTs, please see the information paper at: www.ng.mil/ features/ngps.

PERSONNEL STRENGTH AND QUALITY PROGRAMS The overriding theme of the Army National Guard’s recruiting and retention mission is to sustain a high quality force and continue to improve the quality of life for our Soldiers and their families. The ARNG recalibrated the fiscal year 2009 endstrength mission from 371,000 to 358,200 resulting in a reduction of the recruiting accession mission to a target of 56,000. The endstrength goals focused on achieving historical quality marks in the military entrance exam (the Armed Forces Qualification Test) for high school graduates and an overall retention rate of 106 percent of the ARNG goal. Our sustained recruiting and retention successes are a testament to the outstanding work of our recruiting team and the inherent value of our organization. The ARNG is improving the quality of recruits through the Patriot Academy and the GED Plus programs. Patriot Academy The basic concept for this program came from research that indicated 500,000 students dropped out of high school in 2006. Launched in June 2009, the Patriot Acad- emy enables Soldiers to complete basic training and then perform Title 10 Active Duty for Operational Support while obtaining their high school diplomas, additional military training, and life skills training. The ARNG plans to graduate 500 Soldiers annually. For more details about the Patriot Academy, please see the information paper at: www.ng.mil/features/ngps. GED Plus The GED Plus program provides high school dropouts, 18 and older, basic training and a structured academic environment to earn their GED. To enroll, students must be fully qualified for enlistment and achieve the minimum Armed Forces Qualifica- tion Test score. In fiscal year 2007, some 700 Soldiers passed for a 73 percent success rate. In fiscal year 2008, our success rate jumped to 95.6 percent with 2,457 students passing. The GED Testing team tested 2,283 GED Plus Soldiers in fiscal year 2009 with a passing rate of 96.6 percent. The team was noted as the best test site in the nation by Dantes staff. Also in fiscal year 2009, the National Guard began construction on an $18 million GED Plus educational complex which will increase training capacity to more than 7,500 students per year. 247

As of May 31, 2009, the success rate continues to hover around 95 percent, which is significantly higher than the 69 percent national average achieved by civilian GED programs. The improvement is due in part to grouping students by ability, sharing best practices, and implementing an instructional lab for specific student weaknesses. For more details on the GED Plus program, please see the information paper at: www.ng.mil/features/ngps. Full-time Support The ARNG Full Time Support (FTS) program consists of both Active Guard and Reserve (AGR) Soldiers and Military Technicians and has a direct link to unit readiness. In this continuing era of persistent conflict, FTS personnel are major contributors across the full spectrum of ARNG missions, home and abroad, providing vital strategic depth and continuity of operations. The ARNG is now an Operational Force and its FTS is even more critical to unit readiness. Currently, there is no programmed growth for AGRs while Military Technicians are programmed to increase by 1,170 authorizations by fiscal year 2013. Ongoing manpower studies are determining changes in FTS requirements. Re- sults will be submitted for validation and coordinated with the appropriate organizations for submission in the Program Objective Memorandum process as completed. For more details on FTS, please see the information paper at: www.ng.mil/features/ngps. Medical Readiness With the Army National Guard’s transition to an operational force, the Office of the Chief Surgeon team led medical readiness improvements in fiscal year 2009 by addressing its three primary goals: Support deployment of a healthy force; support deployment of the medical force-units; and facilitate warriors in transition and family care-beneficiaries. Medical readiness increased 13 percent between fiscal year 2008 and fiscal year 2009. This was a direct result of increased targeted funding and stronger liaison efforts between NGB and Army medical commands to meet funding, manning, and equipment requirements. Industrial Hygiene Base funding served to both identify and mitigate preventable health conditions prior to impacting the medical readiness of ARNG units by using three programs—Decade of Health, Hooah4Health (H4H), and blood pressure kiosks. These programs have yielded the following results: —Dental readiness increased 34 percent in fiscal year 2008 and fiscal year 2009; —An estimated 1 million Soldiers checked their blood pressure at kiosks nationwide; and —Over the past 5 years, more than 5,400 Soldier-students have completed the Army’s first interactive, web-based correspondence course on the H4H site with a 97 percent pass rate. Soldier Family Support (SFS) The increased operating and deployment tempo of the Army National Guard has placed additional strain on Soldiers and their Families. In October 2007, the Army initiated the Army Family Covenant program and pledged to provide Soldiers and Families with a quality of life commensurate with their dedicated service and sacrifice to the nation. In fiscal year 2010, the ARNG received an additional $10 million to support and ensure long-term sustainability of SFS functions in support of mission requirements and our role as an operational force. The following SFS programs are currently well underway: —The Personnel Blast and Contaminant Tracker system records data for all service members involved in blast incidents, even when immediate physical symptoms are absent. If the exposure to a blast or contaminant has long-term impacts to the service member, data will be used for line-of-duty benefit evaluation. The ‘‘blast tracker’’ can be expanded to all Army components as well as to the other services. —The Resiliency Training Center, opened in Kansas in 2009, builds resilience in our Soldiers and their families. The center focuses on preventing high stress through proactive marriage workshops and stress relief training before, during, and after deployments. —The Community-Based Warrior Transition Units program provides high-quality healthcare, administrative processing, and transition assistance for recuperating Reserve Component Soldiers while living at home with their families. These Soldiers work at a reserve center within their capabilities. For details about more medical programs, please see the information paper at: www.ng.mil/features/ngps. 248

FACILITIES AND MILITARY CONSTRUCTION Army National Guard facilities are critical to the readiness and capability of the National Guard. These are the locations where our Soldiers perform administration, conduct training, and store and maintain equipment. Additionally, many National Guard facilities are critical rallying points for communities when disaster strikes. Now a combat-proven operational force, the Army National Guard needs adequate facilities to fulfill its crucial role in defending America at home and abroad. The ARNG has over 3,000 readiness centers nationwide. Approximately 1,408 readiness centers are more than 50 years old and are located on five acres or less. Recognized as the hometown ‘‘Armory,’’ these essential facilities may be ‘‘the only military installation for hundreds of miles.’’ For fiscal year 2010, appropriations for Army Na- tional Guard military construction are $582 million. The Army National Guard received over $1.4 billion in military construction funds for fiscal year 2009 which included: —$736 million for 54 projects for the Military Construction Army National Guard program; —$147 million for three emerging requirements projects; —$470 million to construct 14 projects for the base realignment and closure (BRAC) program (ARNG executed 100 percent of these BRAC projects); —$50 million for six construction projects as part of the American Recovery and Reinvestment Act; and —$25 million of fiscal year 2008 funds to assist Mississippi and Indiana with storm damage to their facilities. ARNG Military Construction funding for fiscal year 2010 includes $30 million from the National Guard and Reserve Initiative. These funds are intended to address critical unfunded requirements of the ARNG. Environmental Program Recent success in the ARNG’s environmental program underscores its mission to excel in environmental stewardship which balances community needs with sustaining military readiness. Since the Army Compatible Use Buffer (ACUB) program began in 2003, military funding ($17.5 million) has combined with private funding ($90 million) to protect 40,000 military-acres from encroachment at eight ARNG training centers. For more details about environmental programs, please see the information paper at: www.ng.mil/features/ngps.

EQUIPMENT READINESS Equipment On-Hand (EOH) and Equipment Availability At the end of fiscal year 2009, the Army National Guard had 76 percent of its equipment on-hand. Subtracting equipment that is mobilized and deployed to support Federal missions, the current equipment-on-hand percentage falls to 63 percent of requirements available to the Governors. EOH levels remained fairly flat in fiscal year 2009 as overall requirements increased by 2 percent and equipment inventories rose 3 percent. In many cases, particularly with vehicles, new trucks replaced older legacy vehicles. This kept the EOH relatively constant although capabilities increased due to modernization and an overall decrease in the age of the fleet. Equipment Modernization and Readiness Beginning in fiscal year 2006, the Army significantly increased its investment in ARNG equipment, allocating approximately $25.1 billion for new procurement and recapitalization between fiscal year 2006 and fiscal year 2009. As a result of this investment, the Army National Guard received approximately 296,000 new items in fiscal year 2008 and another 433,000 in fiscal year 2009 at a combined value of $10.2 billion. Additionally, $16.9 billion is currently programmed for Army National Guard equipment between fiscal year 2010 and fiscal year 2015. Despite these successes, the Guard needs to procure and field leading-edge battle command equipment, and improve fill levels for a number of Combat Service Sup- port items such as water purification systems, generators, material handling equipment, field feeding systems, tactical ambulances, and aviation ground equipment. In addition, modernization of the Guard’s truck and helicopter fleets, while absolutely critical to long-term success, will continue to be a challenge well beyond fiscal year 2015. 249

Ground and Air Operating Tempo Ground Operating Tempo The ground operating tempo (OPTEMPO) program is one of the keys to equipment readiness. The program consists of two parts: direct and indirect. Direct ground OPTEMPO pays for petroleum, repair parts, and depot-level repairables. In- direct OPTEMPO pays for expenses such as administrative and housekeeping supplies, organizational clothing and equipment, medical supplies, nuclear, biological and chemical supplies and equipment, and inactive duty training (IDT) travel which includes Command Inspection, staff travel, and cost of commercial transportation. Air Operating Tempo The air OPTEMPO program supports the ARNG flying hour program, which includes petroleum-oil-lubricants, repair parts, and depot-level repairables for the rotary wing helicopter fleet. In fiscal year 2009, air OPTEMPO funding for the Army National Guard totaled $271 million in base appropriation plus $40 million in supplemental for a total of $311 million. This funding provides for fuel and other necessities so that 5,722 ARNG aviators can remain current and proficient in their go-to-war aircraft. Achiev- ing and maintaining desired readiness levels will ensure aircrew proficiency and risk mitigation, which helps to conserve resources. ARNG aviators must attain platoon level proficiency to ensure that they are adequately trained to restore readiness and depth for future operations. Reset Process The Department of the Army programmed the ARNG for $202 million to fund repair parts and the personnel required to repair equipment used in Overseas Contin- gency Operations during fiscal year 2010. The ARNG is planning to Reset 21 brigade-sized elements as well as many units below brigade level. The Reset process also provides additional training for National Guard Soldiers as they repair this equipment. As in previous years, having the ARNG perform its own Field Reset allows for equipment to be returned to the states’ control much faster and repaired in a much more expeditious manner. Logistics-Depot Maintenance The Depot Maintenance Program is an integral part of ARNG sustainment activities. This program is based on a ‘‘repair and return to user’’ system as opposed to the direct exchange system used by the active Army component. In fiscal year 2010, depot surface maintenance program requirements increased by 14 percent. Funding for the ARNG’s surface depot maintenance requirement was increased by 19 percent because of new requirements. In fiscal year 2010 the ARNG plans to overhaul 2,883 pieces of combat and tactical equipment.

TRAINING AND TECHNOLOGY During fiscal year 2009, the ARNG information technology (IT) resources supported the implementation of network security projects, mobilization support, wide area network modernization and redundancy, and emergency response projects. This allowed continued support to each United States Property and Fiscal Office, Joint Forces Headquarters—State, and Army National Guard Headquarters primarily in the National Capital Region. For more details about IT programs, please see the information paper at: www.ng.mil/features/ngps. eXportable Combat Training Capability Soldiers and units are better prepared for mobilization due to the advent of the eXportable Combat Training Capability (XCTC) program. XCTC is an innovative training program that reduces training overhead without sacrificing training quality, standards, or outcomes. This pre-mobilization training program provides tough, realistic training to achieve company level certification and battalion battle staff proficiency. XCTC builds on fundamental tactics, techniques, and procedures by using advanced live, virtual, and constructive training technologies. For more details about the XCTC, please see the information paper at: www.ng.mil/features/ngps. Muscatatuck Training Center The 974-acre Muscatatuck Training Center in Indiana provides a realistic training environment for urban warfare, civil support operations, and emergency response. Trainees include Army National Guard troops, firefighters, police officers, and other first responders. The center’s concentrated urban infrastructure consists 250 of 68 major buildings including a school, hospital, dormitories, light industrial structures, single-family dwellings, a dining facility, and administrative buildings totaling about 850,000 square feet.

LIEUTENANT GENERAL HARRY M. WYATT III, DIRECTOR, AIR NATIONAL GUARD

MESSAGE FROM THE DIRECTOR

AMERICA’S EXCEPTIONAL FORCE, HOME AND AWAY The Air National Guard (ANG), the U.S. Air Force Reserve, and the Regular U.S. Air Force (RegAF) comprise our Total Air Force. The ANG anchors this Total Force team, providing trained and equipped units and personnel to protect domestic life and property; preserving peace, order, and public safety; and providing interoperable capabilities required for Overseas Contingency Operations. The ANG, therefore, is unique by virtue of serving as both a reserve component of the Total Air Force and as the air component of the National Guard. Upon its founding in 1947, the ANG served primarily as a strategic reserve for the U.S. Air Force. Increasingly and dramatically, the ANG has become more of an operational force, fulfilling U.S. Air Force routine and contingency commitments daily. Since 9/11, over 146,000 ANG members have deployed overseas. A snapshot of U.S. forces at any time shows Air Guard members in all corners of the globe supporting joint and coalition forces in mission areas such as:, Security; medical support; civil engineering; air refueling; strike; airlift; and intelligence, surveillance, and reconnaissance (ISR) Currently, over 7,000 ANG members are deployed in Iraq, Afghanistan, and other overseas regions. At 16 alert sites, three air defense sectors, and Northern Com- mand, 1,200 ANG members vigilantly stand watch over America’s skies. Amazingly, 75 percent of our deployed individuals are volunteers, and 60 percent are on their second or third rotations to combat zones. Percentages like these speak volumes about the quality and sense of duty of America’s ANG force! The ANG supports state and local civil authorities with airlift, search and rescue, aerial firefighting, and aerial reconnaissance. In addition, we provide critical capabilities in medical triage and aerial evacuation, civil engineering, infrastructure protection, and hazardous materials response with our Civil Support Teams and our Chemical, Biological, Radiological, Nuclear, and High-yield Explosive (CBRNE) En- hanced Response Force Packages (CERFPs). In the past year, Air Guard members helped their fellow citizens battle floods, fight wildfires, mitigate the aftermath of ice storms, and provide relief from the devastating effects of a tsunami. Here are just a few examples of how the ANG provides exceptional expertise, experience, and capabilities to mitigate disasters and their consequences. —Kentucky, Arizona, and Missouri Guard members responded to debilitating ice storms, which resulted in the largest National Guard call-up in Kentucky’s history. —North Dakota, South Dakota, and Minnesota ANG members provided rescue relief and manpower in response to Midwest flooding. —The Hawaii ANG sent personnel from their CERFP, a command and control element, and a mortuary affairs team to American Samoa in response to an 8.4 magnitude earthquake-generated tsunami. Within the Total Force, the ANG provides extraordinary value in terms of meeting our national defense needs with cost efficiency and immediate availability. In our domestic role, the ANG provides capabilities to support local emergency responders with life and property saving capabilities and expertise not usually found elsewhere in the Total Force.

BEST VALUE FOR AMERICA Building Adaptable Airmen and Priorities for the Future The outstanding men and women of the ANG continue to defend American interests around the world. Throughout 2009, the ANG projected global presence in a variety of missions in regions ranging from the Balkans to Southwest Asia, and from Eastern Europe to Latin America. We have provided much more than airpower, contributing our exceptional capabilities in security, medical, logistics, communications, civil support, and engineering, in order to support our nation’s national security. Our unique community-based heritage has been the foundation of our strength since colonial times. While the strategic environment has continually changed throughout history, the ANG has proven itself an adaptive force, able to meet any new challenges. One reason for our success is that our members normally live in 251 the same communities in which they serve during times of natural disasters or when called upon to respond to national emergencies. Our Guard members know the folks they support very well because they work together, their children attend the same schools, and they shop at the same businesses. Our fellow citizens know the local Guard members and their contributions, and their appreciation has been illustrated through countless welcome home parades and outpouring of support over the years. Throughout history, many of the issues our forebears faced are essentially the same issues we face today: aging capabilities and declining budgetary resources. The ANG has consistently provided the answer in an efficient, cost-effective, community- based force that is ready and responsive to domestic and national security needs. Our traditional, predominantly part-time force continually adapts and evolves toward new missions and capabilities. As a nation, we must ensure America’s ANG continues to be completely interoperable with the RegAF to meet operational and strategic reserve surge requirements. To continue as America’s best value and to meet our national security objectives, the ANG focuses priorities in three areas: —Developing adaptable Airmen for future senior leadership roles and responsibilities; —Modernizing and recapitalizing our warfighting capabilities to ensure we remain completely interoperable with RegAF; and —Evolving and shaping our force to maintain our value to the Air Force mission. Best Value in Personnel, Operations, and Infrastructure During the past year, the ANG has deployed 18,366 service members to 62 countries and every continent, including Antarctica. The ANG provides a trained, equipped, and ready force for a fraction of the cost. We provide a third of Total Air Force capabilities for less than 7 percent of the Total Force budget. In all three areas—personnel, operations, and facilities—the ANG provides the ‘‘Best Value for America.’’ A key to ANG efficiency is our part-time/full-time force structure mix. Our predominantly part-time (traditional) force can mobilize quickly when needed for state disaster response missions, homeland defense, or when we need to take the fight overseas. We have the ability to maintain a stable force with considerably fewer personnel moves than the RegAF, which is a critical factor in our cost-effectiveness. Tradi- tional National Guard members cost nothing, unless on paid-duty status. ANG efficiencies compared to regular military components include: —Fewer ‘‘pay days’’ per year; —Lower medical costs; —Significantly lower training costs beyond initial qualification training; —Virtually no costs for moving families and household goods to new duty assignments every 3 or 4 years; —Fewer entitlements, such as basic allowance for housing; and —Lower base support costs in terms of services and facilities including commissaries, base housing, base exchanges, and child care facilities. The ANG is an operational reserve with surge potential of 2,200 mobilized and 5,700 volunteering per day. If this force were full-time active duty (as is the RegAF), the military personnel budget would be $7.62 billion. ANG military personnel pay in fiscal year 2009, including military technician pay, was $4.77 billion for a yearly cost savings of $2.85 billion, or a daily cost savings of $7.8 million. Whether compared to another major command (MAJCOM), the RegAF, or even to the militaries of other countries, the ANG is an extraordinary value. In direct comparison with the militaries of France and Italy, for example, our ANG members cost $76,961 per member, while the bills of those countries respectively run to $128,791 and $110,787 per member. Further, cost per ANG member is less than a fifth of that of the RegAF. Comparisons such as these illustrate well the cost savings realized with an operational reserve possessing surge potential. Operational savings are due to the ANG’s experienced force and lean operating methods. An examination of the ANG’s F–16 maintenance by Rand Corporation last year highlighted the ability of our maintenance personnel to generate double the amount of flying hours in a one-to-one comparison of full-time equivalents. Savings from ANG infrastructure start with basing at civilian facilities. With some ANG base leases costing as little as one dollar annually, the ANG is able to realize even more cost savings for the Total Force through our supporting infrastructure. Three-fourths of ANG bases are located at civilian airports. In fact, our Joint Use Agreements with civilian airports provide access to approximately $12 billion in infrastructure for less than $5 million annually. 252

Significantly, the ANG is a dual-use force of people and equipment. As indispensable as the ANG is to the Air Force, it is equally indispensable to the National Guard’s domestic response capability. The ANG leverages the vast majority of its equipment in this dual role, from the movement of time-sensitive cargo and passengers during a domestic crisis to providing critical capabilities needed to support Total Force requirements overseas. Recruiting and Retention Our ability to conduct missions important to our states and nation rely on our people, which requires successfully recruiting and retaining our members. We are fortunate that our retention numbers have remained strong throughout 2009, at 90.8 percent, which beat our goal of 90 percent. This is a testament to the outstanding work of our recruiting and the inherent value of our organization. We focus our efforts in areas where we face challenges. Officer recruiting and other critical areas include healthcare, engineers, intelligence, mobility pilots, and chaplains. During 2009, we began linking recruiting and retention efforts to our strategic planning functions. This allowed the ANG to better position our force for new missions and align more effectively with shifts in the Air Force capabilities portfolio. Those new ANG members with prior service are particularly valuable for the ANG and constitute more than 50 percent of our recruits. Developing Future Leadership in the Total Force In developing adaptable Airmen, we are focusing on initiatives to prepare our Air- men for future Total Force leadership. Developing this leadership capability requires both increased in-residence opportunities at all Developmental Education schools and increased opportunities for joint service. Additionally, command opportunities must be afforded in theater, commensurate with the presence of all forces deployed to the warfight. One of our recent initiatives involved redesigning our statutory tour program to provide more opportunities for developing critical command and staff experiences for personnel at the National Guard Bureau and in the field. Through this two-way flow, we improve insights and perspectives that will help develop adaptable Airmen.

PROTECTING AMERICA’S FUTURE Modernization and Recapitalization The age of the ANG fleet continues to be of grave concern. Meeting future challenges at home and abroad will require modernization and recapitalization of both aircraft and equipment in the RegAF and the ANG. Concurrent and proportional equipping of the ANG within the Total Force ensures continued interoperability with the RegAF. America cannot afford to fall behind in air supremacy. Continued dominance depends on modernizing and recapitalizing planes and equipment, and adapting to the strategic environment while maintaining our technological advantages. Without concurrent recapitalization, the U.S. Air Force stands to lose 80 percent of its current Air Sovereignty Alert force for homeland defense in 7 years. Similarly, even as older KC–135 air refueling tankers retire, we nearly double the annual flight hours for the newer KC–135R/T, which hastens the aging process. Without suitable replacements, the current Combat and Mobility Air Forces face increasing maintenance and safety issues over the coming years, which will undoubtedly affect mission execution and accomplishment. It is essential to concurrently and proportionally maintain qualified pilots in the ANG who can provide operational surge capability to the Total Force in times of war, and lessen the burden of high operations tempo faced by the RegAF. Dual-Use Capabilities The ANG provides the balance at home and abroad through fielding of ‘‘dual-use’’ capabilities, a cornerstone of the ANG’s cost effective contribution to the Total Force. We assist the RegAF as they respond to the needs of the Combatant Com- manders. Comparable capabilities also protect the homeland and defend America’s skies. As part of the Total Force mission, the ANG requires capabilities to defend against today’s threats, and to assist our states, territories, and the District of Co- lumbia in domestic missions, such as disaster response. We also continue to develop ways to take advantage of the cost effectiveness inherent in the ANG, such as maximizing associations and community basing. Total Force Integration (TFI) Total Force Integration is the method and process by which Air Force components leverage the inherent strengths of their respective forces and blend their equipment 253 and capabilities to achieve maximum effectiveness across the full spectrum of air operations. The ANG provides the best value by applying its component-specific efficiencies to Total Force operations and by taking on missions that are appropriate to its cultural and operational composition. The cost savings offered by the ANG are not derived solely from its part-time force construct. Significant cost-effectiveness is realized in the streamlined operations and limited infrastructure costs unique to the ANG, as well as initiatives that combine RegAF and ANG personnel, equipment, and aircraft at associate units. The associate unit constructs increase Total Force responsiveness to national needs by integrating RegAF and ANG-specific mission capabilities, and by combining the facilities, training, combat support, and logistical infrastructures that maximize combat capability. Three prime examples of this construct are the most recently created associate wings, all of which perform aerial refueling missions in KC–135 Stratotankers: 126th Air Refueling Wing (ARW) at Scott Air Force Base, Illinois; 157 ARW at Pease Air National Guard Base (ANGB), New Hampshire; and 117 ARW at Birmingham ANGB, Alabama. Planning for Future Missions The ANG is working with the Adjutants General to update and refine recapitalization and modernization plans through the ANG Flight Plan, a field-driven process in coordination with our Strategic Planning System (SPS) that will help position ANG units for future missions. The SPS enables the ANG to systematically develop plans that make sense for our states and the nation and position the ANG to support the Total Force in the future. Intelligence, Surveillance, and Reconnaissance (ISR) The ANG sees opportunities to contribute further to the Total Force in mission areas such as ISR. Our military’s increasing focus on special operations and analysis are two areas in which the ANG can help meet increasing demand. One such area is addressed by the RC–26, the ANG’s only dedicated, light- manned ISR aircraft that supports Special Operations Forces. Within the domestic mission, the RC–26 is the ANG’s premier aircraft for Incident Awareness and As- sessment for National Special Security Events, counter narcotics, homeland security, and response to natural or man-made disasters. The ANG continues to seek Air Force recognition and assignment of a Major Command for this aircraft. The ANG also operates Remotely Piloted Aircraft (RPA) and has been involved in this rapidly emerging mission area since 2004. Today, five states operate nine RPAs in combat air patrols in theater, and we anticipate even greater involvement in the future. One of these units, the New York ANG’s 174th Fighter Wing at Hancock Field ANGB in Syracuse, now operates the MQ–9 Reaper in support of operations in Afghanistan, sending commands to the RPA through satellite networks. This wing, which formerly had an F–16 flying mission, is the first Air Guard unit to operate MQ–9s and to open the Air Force’s only MQ–9 maintenance schoolhouse this year. Space and Cyberspace As we look to the future, the ANG is well positioned to assist Air Force missions by virtue of the continuity and civilian skills we provide. For example, our Air Guard members’ civilian skills are well suited to help the Air Force meet various mission requirements in areas such as cyber security, where the ANG already has eight operational units dedicated to deterring attacks on our nation’s cyber networks. In space operations, Air Force Space Command looks to the ANG to provide support in areas such as missile operations, Distributed Command and Control Mis- sions, and space launch/range operations. ANG efficiencies and initiatives such as TFI help the Total Force mission requirements in areas such as missile warning associate squadrons. Building Partnership Capacity In the emerging mission areas of Irregular Warfare/Building Partners/Building Partnership Capacity, the ANG seeks to enhance its ability to meet domestic needs, as well as sufficient force structure to meet the demands of steady state deployments. We are engaged in Light Attack and Armed Reconnaissance (LAAR) testing and numerous Agile Combat Support mission areas. We plan to increase tactical and direct support airlift capacity, such as light mobility aircraft and rotary wing aircraft, as well as increase our ISR capacity and LAAR capabilities. 254

Continuing Missions The ANG will retain some conventional mission sets, particularly those associated with Global Persistent Attack. For example, the ANG is well suited for missions requiring surge aircraft in the early stages of a large conflict because of our cost-effectiveness continuity-of-experience. The ANG must also continue to participate in missions such as Rapid Global Mobility, which includes: Strategic airlift (C–5, C–17); Intra-theater or tactical airlift (C–130, C–27); and Air refueling (KC–135, KC–10, and future platforms). ANG combat aircraft (A–10, F–15, and F–16) make up a third of the combat capability of our nation’s Air Force. Additionally, the ANG defends America’s air space by conducting the Air Sovereignty Alert (ASA) mission at 14 of 16 sites throughout the country. The F–16s used in this critical mission will reach their service life ex- pectancy in 7 years. While our maintainers continue to keep our fleet mission ready and capable, these ‘‘legacy’’ systems should be replaced as soon as practical for the Air Force to remain relevant and reliable. The ANG will continue to retain existing missions that provide surge capability, such as those involved in Global Persistent Attack. Our nation’s Air Force Reserve Components are particularly well suited in this role, providing unmatched cost effectiveness. Many of our tactical airlift missions, as well as Agile Combat Support missions, such as medical support, services, security forces, civil engineers, transportation, and logistics support, provide dual-use capabilities that are an extraordinary value provided only by the ANG. Rebalancing the force and training for new missions will directly impact thousands of Air Guard members nationwide. With the continued support of Congress, the ANG will continue to develop and field the most capable, cost-efficient force for fiscal year 2011 and well into the future. The members of America’s ANG will continue to serve with pride and distinction at home and abroad. The ANG is an exceptional force, both in terms of the cost-effectiveness and in the quality and flexibility of our force. We continually strive to improve our capabilities and support the Total Force effort. We look forward to the future with great anticipation, secure in the knowledge that our nation’s Air National Guard provides unsurpassed value for America.

MAJOR GENERAL MICHAEL H. SUMRALL, ACTING DIRECTOR, JOINT STAFF, NATIONAL GUARD BUREAU

MESSAGE FROM THE DIRECTOR Today’s prolonged worldwide irregular campaign against the forces of violent extremism requires global engagement across the spectrum of conflict. The challenge for the National Guard, as well as for the military as a whole, is to maintain the skills necessary to help struggling nations fight extremism while addressing the conditions that allow extremist groups to exist. The real challenge lies at the heart of what it means to be a successful, thriving democracy—the relationship among the populace, elected officials and government, and the military. Fortunately, the competitive advantage of the National Guard is its ability to build the bridges between civil and military authorities. We do this on a daily basis at home, and we are increasingly able to translate this capability to our Title 10 responsibilities abroad. In 2009, we made great strides in domestic planning efforts between U.S. North- ern Command and National Guard Bureau (NGB). The National Guard has long been well prepared for commonly occurring natural disasters such as hurricanes, wildfires, winter storms, and flooding. Preparing for less likely but catastrophic events requires an even more inclusive approach to planning. In recent years, the National Guard has developed innovative capabilities such as the Weapons of Mass Destruction Civil Support Teams (WMD–CST) and Chemical, Biological, Radiological, Nuclear and High-yield Explosive (CBRNE) Enhanced Re- sponse Force Package (CERFP) to respond to CBRNE events.

DOMESTIC OPERATIONS Here are some examples of how the National Guard adds value to America: Weapons of Mass Destruction Civil Support Teams (WMD–CST) The National Guard will add two new WMD–CST units, bringing the total to 57 units. Each unit consists of 22 full-time Army and Air Guard personnel. WMD– CSTs help each state’s civil authorities in identifying CBRNE agents, assessing current and projected consequences, advising on response measures, and assisting with appropriate requests for additional support. 255

Chemical, Biological, Radiological, Nuclear and High-yield Explosive Enhanced Re- sponse Force Package (CERFP) Seventeen CERFPs became fully operation capable in March 2009. This achievement helped to bridge the gap of a needed capability for a CBRNE response. These professionals train with Federal, state, and local agencies, and include the Marine Corps Chemical Biological Incident Response Forces (CBIRF) and FEMA Urban Search and Rescue. In addition, a number of teams deployed to support national special security events such as the State of Union Address, Presidential Inaugura- tion, and Republican/Democratic National Conventions, and will deploy to many others as the knowledge of this capability grows within the domestic operations community. Homeland Response Force (HRF) The National Guard has been directed by DOD to create 10 HRFs: two in fiscal year 2011 and eight in fiscal year 2012. The HRF will be made up of those early, life-saving capabilities including Search and Rescue, Decontamination, Emergency Medical, Security, and Command and Control (C2), with approximately 566 personnel per HRF. The 10 HRFs, 17 CERFPs and 57 CSTs will provide the initial military response to a CBRNE incident. CBRNE Consequence Management Response Force (CCMRF) Whether deliberate or inadvertent, CBRNE incidents are one of the greatest challenges facing our nation today. Accordingly, DOD developed the CCMRF concept: a task force of approximately 5,200 service members who operate under the authority of Title 10 of the U.S. Code. The CCMRF is designed to augment the consequence management efforts of state and local first responders, conventional National Guard forces, and Federal agencies by providing complementary and unique capabilities when the effects of a CBRNE incident exceed state capabilities. Restructured CCMRF 1 capabilities include CBRNE assessment, search/rescue, decontamination, emergency medical security, logistic support, and C2. CCMRF 2 and 3 each consist of a 1,200 personnel C2 element to provide additional command and control capability if required during a major incident. Critical Infrastructure Program (CIP) National Guard Critical Infrastructure Protection (CIP) assessment teams conduct all-hazard vulnerability assessments of prioritized Defense Industrial Base (DIB) and Department of Homeland Security (DHS) Tier II sites in support of the Depart- ments of Defense and Homeland Security. DIB CIP Teams are manned by a joint team consisting of nine traditional Air and Army National Guard members. The team consists of a team leader, mission analyst, electrical specialist, transportation specialist, water, heating, ventilating and air conditioning specialist, communications specialist, a petroleum, oil, and lubrica- tion specialist, and security operations and emergency management. These teams conduct mission assurance assessments of prioritized Defense Industrial Base assets. DHS CIP Teams are manned by a joint team consisting of three traditional Air and Army National Guard members. These teams conduct assessments based on Department of Homeland Security criteria of DHS-selected critical assets. In fiscal year 2009, NGB CIP teams assessed over 200 industrial sites and critical U.S. Government infrastructure for vulnerabilities to attack. The teams anticipate assessing 200 more in fiscal year 2010. For more details on CIP, please see the information paper at: www.ng.mil/features/ngps. National Guard Reaction Force (NGRF) A critical element in the first line of counter-terrorism defense, the NGRF is designed to respond to an incident ahead of Federal assets with the capability to be logistically self-sustaining for up to 72 hours. Reaction Forces provide every state with a ready combat arms force capable of delivering, at the request of the Governor or President, an initial force package of 75–125 personnel who can respond within 8 hours. A follow-on force of up to 375 personnel can arrive within 24 hours. In fiscal year 2009, states and territories used their NGRFs to support the Presidential Inauguration and numerous other events and emergencies. For more details about the National Guard Reaction Force, please see the information paper at: www.ng.mil/features/ngps. Joint Enabling Team The National Guard Bureau Joint Enabling Team (JET) provides critical NGB Joint Staff, Army, and Air National Guard expertise to support the state or territory during a crisis event. In essence, when a disaster strikes, NGB will assist with re- 256 porting and coordination of NGB support. JETs will be on site within 24 hours of decision to execute. JETs have satellite phones, laptops and printers, cell phones, communications gear, and any other equipment needed to ensure a successful mission. The Team arrives self-sufficient and sustaining. NGB can field up to four JETs simultaneously. Joint Incident Awareness and Assessment Team (JIT) Incident Awareness and Assessment (IAA) is a key enabler that leverages traditional DOD and other governmental intelligence, surveillance, and reconnaissance (ISR) capabilities to support domestic operations while strictly adhering to all applicable legal frameworks. The JIT, a select, highly trained, fly-away team, assists the state Joint Force Headquarters (JFHQ-State) in crisis response with expertise in IAA planning, tasking, acquisition, processing, assessment, and dissemination to appropriate responders during an incident. Counterdrug Programs The National Guard Counterdrug Program conducts a full spectrum campaign that bridges the gap between the Department of Defense and non-DOD institutions in the effort against illicit drugs and transnational threats to the homeland. The Counterdrug Program supports all levels of government, including DOD, law enforcement and community-based counterdrug operations to anticipate, prevent, deter and defeat those threats in order to enhance national security and protect our society. The National Guard Bureau Counterdrug Program is part of the national drug control strategy. Initially authorized by the President and Congress in 1989, DOD provides funds on a yearly basis to state Governors who submit plans specifying the usage of each state’s National Guard to support drug interdiction and counterdrug activities. The National Guard brings three unique qualities to the Counterdrug problem: Trained Citizen-Soldiers and Airmen with unique military skills and equipment; legal status as a state militia (exempt from posse comitatus); and ties to the more than 3,200 local communities where National Guardsmen and women live and serve. In fiscal year 2009, approximately 2,600 National Guard personnel provided counterdrug support to law enforcement agencies in seizing drugs, weapons, and other contraband. During fiscal year 2009, counterdrug academies in Iowa, Florida, Mississippi, and Pennsylvania trained a total of 97,092 students which included: 4,278 military personnel, 23,918 community coalition members, and 68,896 law enforcement students. The National Guard’s anti-drug program ‘‘Stay-On-Track’’ (SOT) has reached over 160,000 youth since 2006. We expect to expand SOT and reach out to 120,000 students in fiscal year 2010. For more details about the National Guard’s Counterdrug program, please see the information paper at: www.ng.mil/features/ngps. National Guard Prioritized Capability Gaps Section 351 of the National Defense Authorization Act (NDAA) for fiscal year 2008 directs DOD to provide an assessment of the extent to which the National Guard possesses the equipment required to perform its responsibilities in response to an emergency or major disaster. The assessment is to: —Identify any equipment shortfall that is likely to affect the ability of the Na- tional Guard to perform such responsibilities. —Evaluate the effect of any shortfall on the capacity of the National Guard to perform such responsibilities in response to an emergency or major disaster. —Identify the requirements and investment strategies for equipment provided to the National Guard by the Department of Defense that are necessary to plan for a reduction or elimination of any such shortfall. In response to this requirement, NGB developed its own Capability Assessment and Development Process (CADP), which is modeled after Chairman, Joint Chiefs of Staff processes for analyzing mission functions and capabilities, and determining gaps/shortfalls and solutions. The CADP supports NGB’s ability to assess current and future capability needs to respond to domestic events, and to articulate those needs in appropriate planning, programming, and budgeting forums. The National Guard Bureau conducted regional scenario-based exercises in 2008 that provided data for the National Guard CADP. Subsequent analyses enabled the National Guard Bureau to identity and prioritize several capability gaps and develop recommendations for: —Improving command and control (C2), communications, interagency information sharing, and capacity to conduct domestic operations. 257

—Improving National Guard Chemical, Biological, Radiological, Nuclear, and high-yield Explosive (CBRNE) disaster response capabilities. —Increasing joint and interagency training and readiness. The National Guard Bureau is working through appropriate plans, programs, and budgetary processes in order to obtain the necessary resources to mitigate identified National Guard capability gaps and improve National Guard capabilities for Home- land Defense and Civil Support.

JOINT AND INTERAGENCY TRAINING The NGB is leading the total force in a ‘‘Race to the Top’’ that postures the Na- tional Guard as the most effective joint force for domestic military operations. This endeavor started with a training transformation (T2) in NGB’s Joint Interagency Training Capability (JITC) programs. NGB advanced T2 from a vision to reality in fiscal year 2009 by investing in new joint training and education, and by integrating joint exercises and training capabilities with interagency partners. T2 will emphasize JITC programs in fiscal year 2010 and beyond that produce experienced leaders and staff officers who are joint-minded, innovative, and who can adapt to the operational contexts of an event. The final objective of T2 is a fully joint force of motivated people who are well-trained, well-educated, and exercised to accomplish their joint mission essential tasks (JMETs). Joint Interagency Training Capability (JITC) programs Since its inception, JITC has prepared the National Guard by providing more than 30,000 man-days of individual, staff, and collective training in over 800 events. NGB plans to conduct over 200 events in fiscal year 2011. Vital JITC programs include: Defense Support of Civil Authorities (DSCA) Training DSCA training uses simulations and linked Live-Virtual-Constructive environments to enhance training for homeland defense and emergency response missions. Joint Task Force (JTF) Commander Training Course This 5-day course provides current and future JTF commanders with an understanding of directives, current policies, guidance, and lessons learned regarding the complexities of commanding a JTF. Joint Staff Training Course This 6-month course blends distance learning with face-to-face sessions to train joint force staff personnel in all aspects of joint operations, planning, and execution to prepare them to act in concert with other joint, interagency, and intergovernmental organizations. Standardized CBRNE Collective Training This program trains CERFP, WMD–CST, and NGRF teams to provide an immediate response capability to support civil and military authorities following a CBRNE incident by forensically identifying the contamination; locating, extracting, decontaminating, and medically treating victims; and providing responders with security.

VIGILANT GUARD Each year, the National Guard conducts four regional Vigilant Guard (VG) exercises to help military first-responders unify their efforts to support civilian authorities. In 2009, regional VG exercises were hosted by Iowa, Montana, New York, and Puerto Rico, with many other states contributing. The NGB is also building a special Vigilant Guard exercise to support the 54 states and territories in preparing for larger scale or real-world events. Implementation will begin in fiscal year 2011. Emergency Response and Training The National Guard’s Joint Incident Site Communications Capability (JISCC) provides communications capabilities for the National Guard while conducting domestic operations and providing military support to civil authorities. With 85 deployed systems, JISCC is available for utilization anytime and anywhere. It provides interoperable communications and emergency satellite links to command and control centers to share information and tools needed to support collaboration with other Fed- eral, state, and local responders including FEMA, the Department of Homeland Se- curity (DHS), and state emergency management agencies. The success of JISCC’s anytime and anywhere communications capability in supporting domestic operations has received recognition and support from the military departments. The NGB and Army and Air Force are assessing it for future develop- 258 ment as a programmed and funded defense communications system. The JISCC system, in conjunction with a web-based application (Joint Information Exchange Envi- ronment), and a Command and Control Coordination Center (C4) are known collectively as the Joint CONUS Communications Support Environment (JCCSE). Together, JCCSE’s three elements offer the states and territories, Combatant Commanders, and domestic operations partners a complete communications package for emergency management/response: Deployable communication equipment; situational awareness and common operating picture capability; and a center for coordinating emergency operations. Partial funding for sustainment of the three JCCSE elements has been recognized in the fiscal year 2010–15 defense budget.

SUPPORTING THE WARFIGHTER AND FAMILY Financial Management Awareness Program In 2009, the National Guard Bureau established the Consumer Education and Fi- nancial Services Program. Working with defense, government, and civilian agencies, the program educates members of the National Guard and their families on financial responsibility and provides them with the necessary resources available to help them make sound financial decisions. Financial health is essential to the National Guard’s preparedness and is an important quality-of-life issue. Continued collaboration among all agencies will ensure that every National Guard member and each family can understand and access the myriad of available financial resources. Websites: http://www.militaryhomefront.dod.mil/; http:// www.myarmyonesource.com; and http://www.jointservicessupport.org/. The Yellow Ribbon Reintegration Program (YRRP) provides information, services, referrals, and proactive outreach to Service members, families and employers throughout pre-deployment, deployment, and post-deployment. Through May 2009, the National Guard has already conducted 619 events involving 47,182 service members and 58,350 family members. Youth Development Our Citizen-Soldiers who, in their civilian lives, are influential across the spectrum of business, education, and government make up the backbone of the National Guard Youth ChalleNGe program. The award-winning community-based program leads, trains, and mentors at-risk youth to become productive citizens in America’s future. ChalleNGe has 32 sites in 28 states and Puerto Rico, offering a 5-month ‘‘quasi-military’’ residential phase and a 1-year post-residential mentoring phase for unemployed, crime-free high school dropouts, ages 16–18. Since 1993, ChalleNGe has graduated over 90,000 students. Over 67 percent have earned a GED or high school diploma and 12 percent enter the military. The program pays for itself by savings realized from keeping young people out of jail and off public assistance rolls. Based on a formula from a 1998 Vanderbilt University study, ChalleNGe saves approximately $175 million annually in juvenile corrections costs, while keeping youth off of Federal assistance. For more details on the National Guard Youth ChalleNGe program, please see the information paper at: www.ng.mil/features/ngps. DOD STARBASE Program Thirty-four National Guard sites host the DOD STARBASE Program which reaches out to at-risk 5th grade students to improve their knowledge and interest in the science, technology, engineering, and math fields. The United States faces a workforce and educational crisis in these fields as American 15-year-olds rank near the bottom of 30 countries in combined science and math test scores. The program exposes the students to advanced technology and positive role models found on military bases and installations. For more details on the DOD STARBASE program, please see the information paper at: www.ng.mil/features/ngps. A Leader in Equal Opportunity The NGB Office of Equal Opportunity (NGB–EO) provides direction, administration, management, and policy implementation of National Guard (NG) military Equal Opportunity (EO) and technician Equal Employment Opportunity (EEO) and Civil Rights programs to both Army and Air Force. NGB–EO ensures the effective management of NG Affirmative Action Programs to achieve a military and civilian workforce structure that is reflective of the diversification of the 54 states, territories, and the District of Columbia. NGB–EO also oversees the implementation of programs that focus on the special needs of employees with disabilities. People with disabilities can be hired through 259 the traditional competitive hiring process or if they qualify, noncompetitively through the use of accepted service appointing authorities. NGB–EO is responsible for providing educational awareness about Wounded Warriors, reasonable accommodations, and employment opportunities through various programs. As an employer, the National Guard recognizes that all employees with disabilities and wounded service members are essential to our workforce and have demonstrated excellence in executive, administrative, managerial, and technical fields.

STATE ADJUTANTS GENERAL Alabama: Major General Abner C. Blalock Jr. Alaska: Brigadier General Thomas H. Katkus Arizona: Major General (AZ) Hugo E. Salazar Arkansas: Major General William D. Wofford California: Brigadier General Mary J. Kight Colorado: Major General H. Michael Edwards Connecticut: Major General Thaddeus J. Martin Delaware: Major General Francis D. Vavala District of Columbia: Major General Errol R. Schwartz, Commanding General Florida: Major General Douglas Burnett Georgia: Major General William T. Nesbitt Guam: Major General Donald J. Goldhorn Hawaii: Major General Robert G. F. Lee Idaho: Major General (ID) Gary L. Sayler Illinois: Major General William L. Enyart Indiana: Major General R. Martin Umbarger Iowa: Brigadier General Timothy E. Orr Kansas: Major General Tod M. Bunting Kentucky: Major General Edward W. Tonini Louisiana: Major General Bennett C. Landreneau Maine: Major General (Ret) John W. Libby Maryland: Brigadier General (MD) James A. Adkins Massachusetts: Major General (MA) Joseph C. Carter Michigan: Major General Thomas G. Cutler Minnesota: Major General Larry W. Shellito Mississippi: Major General (MS) William L. Freeman, Jr. Missouri: Brigadier General (MO) Stephen L. Danner Montana: Brigadier General (MT) John E. Walsh Nebraska: Brigadier General (NE) Judd H. Lyons Nevada: Brigadier General William R. Burks New Hampshire: Major General (NH) William N. Reddel III New Jersey: Major General Glenn K. Rieth New Mexico: Major General (NM) Kenny C. Montoya New York: Brigadier General Patrick A. Murphy North Carolina: Major General William E. Ingram, Jr. North Dakota: Major General David A. Sprynczynatyk Ohio: Major General Gregory L. Wayt Oklahoma: Major General Myles L. Deering Oregon: Major General Raymond F. Rees Pennsylvania: Major General Jessica L. Wright Puerto Rico: Major General (PR) Antonio J. Vicens-Gonzalez Rhode Island: Major General Robert T. Bray South Carolina: Major General (Ret) Stanhope S. Spears South Dakota: Major General Steven R. Doohen Tennessee: Major General (TN) Terry M. Haston Texas: Major General Jose S. Mayorga Jr. Utah: Major General Brian L. Tarbet Vermont: Major General Michael D. Dubie Virginia: Major General Robert B. Newman Jr. Virgin Islands: Brigadier General (VI) Renaldo Rivera Washington: Major General Timothy J. Lowenberg West Virginia: Major General Allen E. Tackett Wisconsin: Brigadier General (WI) Donald P. Dunbar Wyoming: Major General Edward L. Wright

IN MEMORIAM A special dedication to the men and women of the Army and the Air National Guard who made the ultimate sacrifice while serving the United States of America. 260

National Guard Soldiers and Airmen lost during the attacks on 9/11, Operation Noble Eagle, Operation Enduring Freedom, and Operation Iraqi Freedom as of Jan- uary 1, 2010. SGT Christopher P. Abeyta, IL CPL Samuel M. Boswell, MD CPT Clayton L. Adamkavicius, KY SSG Collin J. Bowen, MD PVT Algernon Adams, NC PFC Samuel R. Bowen, OH SGT. Roger L. Adams Jr, NC SGT Larry Bowman, NY SGT Ryan C. Adams, WI SSG Hesley Box Jr., AR SFC Brent A. Adams, PA SSG Stacey C. Brandon, AR SGT Leonard W. Adams, NC SPC Kyle A. Brinlee, OK SGT Spencer C. Akers, MI SSG Paul F. Brooks, MO SPC Segun F. Akintade, NY SSG Cory W. Brooks, SD PFC Wilson A. Algrim, MI SFC John G. Brown, AR SPC Azhar Ali, NY SGT Lerando Brown, MS SGT Howard P. Allen, AZ PFC Nathan P. Brown, NY 1LT Louis E. Allen, PA PFC Oliver J. Brown, PA SSG William A. Allers III, KY SPC Philip D. Brown, ND SFC Victor A. Anderson, GA SPC Timothy D. Brown, MI SPC Michael Andrade, RI SGT Charles R. Browning, AZ SGT Jan M. Argonish, PA SFC Daniel A. Brozovich, PA SGT Travis M. Arndt, MT SSgt Andrew C. Brunn, NY SSG Daniel L. Arnold, PA SPC Jacques E. Brunson, GA SSG Larry R. Arnold, MS PFC Paul J. Bueche, AL SGT Jesse A. Ault, VA CPL Jimmy D. Buie, AR SPC Adrian L. Avila, AL SSG James D. Bullard, SC SGT Christopher J. Babin, LA SPC Alan J. Burgess, NH SFC Travis S. Bachman, KS SSG Jason E. Burkholder, OH SSG Nathan J. Bailey, TN SGT Casey. Byers, IA SPC William L. Bailey, NE SGT Charles T. Caldwell, RI SPC Ronald W. Baker, AR MAJ Jeffrey R. Calero, NY SGT Sherwood R. Baker, PA SPC Norman L. Cain III, IL SGT Juan C. Baldeosingh, NC SSG Joseph Camara, MA MSG Scott R. Ball, PA 1LT Jaime L. Campbell, WA 1LT Debra A. Banaszak, IL LTC David C. Canegata III, VI SGT Derek R. Banks, VA SGT Deyson K. Cariaga, HI 1LT Gerard Baptiste, NY SPC Frederick A. Carlson, PA SGT Michael C. Barkey, OH SSG Nicholas R. Carnes, KY 1LT Leevi K. Barnard, NC SPC Jocelyn L. Carrasquillo, NC 1LT Christopher W. Barnett, LA MSG Scott M. Carney, IA SPC Bryan E. Barron, MS SGT James D. Carroll, TN SGT Michael Barry, KS SPC Dane O. Carver, MI SSG Robert J. Basham, WI SGT Frank T. Carvill, NJ SPC Todd M. Bates, OH SFC Virgil R. Case, ID SSG Mark C. Baum, PA CPT Christopher S. Cash, NC SSG Tane T. Baum, OR SPC Stephen W. Castner, WI SFC John C. Beale, GA SPC George W. Cauley, MN SPC Alan Bean Jr., VT SPC Jessica L. Cawvey, IL SGT Bobby E. Beasley, WV CPL Bernard L. Ceo, MD SSgt Brock A. Beery, TN SPC James A. Chance III, MS CPL Joseph O. Behnke, NY SSG William D. Chaney, IL SGT Aubrey D. Bell, AL MSG Chris S. Chapin, VT SSG Keith A. Bennett, PA SGT Brock H. Chavers, GA SGT Darry Benson, NC SSG Craig W. Cherry, VA SPC Bradley J. Bergeron, LA SPC Don A. Clary, KS LTC Richard J. Berrettini, PA MSG Herbert R. Claunch, AL SSG David R. Berry, KS SGT James M. Clay, AR SSG Sean B. Berry, TX SPC Brian Clemens, IN SSG Harold D. Best, NC SSG Thomas W. Clemons, KY SGT Robert L. Bittiker, NC SGT Russell L. Collier, AR 1SG John D. Blair, GA SFC Kurt J. Comeaux, LA SSG Richard A. Blakley, IN SPC Anthony S. Cometa, NV SGT Dennis J. Boles, FL SGT Brian R. Conner, MD SFC Craig A. Boling, IN SFC Sean M. Cooley, MS SSG Jerry L. Bonifacio Jr., CA SSG Travis S. Cooper, MS SSG Darryl D. Booker, VA SPC Marcelino R. Corniel, CA COL Canfield Boone, IN SGT Alex J. Cox, TX SPC Christopher K. Boone, TX SFC Daniel B. Crabtree, OH 261

MSG Clinton W. Cubert, KY SSG Jacob Frazier, IL SSG Daniel M. Cuka, SD SSG Alex French IV, GA SPC Carl F. Curran, PA SPC Carrie L. French, ID CPT Patrick D. Damon, ME SPC Armand L. Frickey, LA SGT Jessie Davila, KS SSG Joseph F. Fuerst III, FL SPC Daryl A. Davis, FL SFC Michael T. Fuga, AS 1 SSG Kevin D. Davis, OR SSG Carl R. Fuller, GA SPC Raphael S. Davis, MS SPC Marcus S. Futrell, GA SSG David F. Day, MN CSM Marilyn L. Gabbard, IA PFC John W. Dearing, MI SPC Joseph L. Gallegos, NM SGT Germaine L. Debro, NE SGT Jerry L. Ganey Jr., GA MSG Bernard L. Deghand, KS SGT Seth K. Garceau, IA SGT Felix M. Del Greco, CT SPC Tomas Garces, TX SPC Daryl T. Dent, DC SGT Landis W. Garrison, IL SPC Daniel A. Desens, NC PFC Alva L. Gaylord, MO CPT Bruno G. Desolenni, CA SGT Christopher Geiger, PA PFC Nathaniel E. Detample, PA SPC Christopher D. Gelineau, ME CPL Scott G. Dimond, NH SPC Mathew V. Gibbs, GA SPC Joshua P. Dingler, GA 2LT Richard B. Gienau, IL SGT Philip A. Dodson Jr., GA SSG Charles C. Gillican III, GA SPC Ryan E. Doltz, NJ SGT Terrell W. Gilmore, LA SSgt Geronimo ‘‘Jerome’’ M. P. SPC Lee M. Godbolt, LA Dominguez, NY SGT Jaime Gonzalez, TX 1LT Mark H. Dooley, NY CPL Nathan J. Goodiron, ND SPC Thomas J. Dostie, ME SPC Richard A. Goward, MI SSG George R. Draughn Jr., GA SGT Shawn A. Graham, TX SGT Duane J. Dreasky, MI SFC Alejandro Granado, VA SPC Daniel P. Drevnik, MN SGT Jamie A. Gray, VT SPC Christopher M. Duffy, NJ SPC Anthony G. Green, NC CPL Ciara M. Durkin, MA SGT Kevin D. Grieco, IL SGT Arnold Duplantier II, CA SPC James T. Grijalva, IL MSG Kevin A. Dupont, MA SGT Shakere T. Guy, CA Sgt Lance O. Eakes, NC SGT Jonathon C. Haggin, GA SPC Chad A. Edmundson, PA SFC Peter J. Hahn, LA SFC Amos C. Edwards Jr., GA CSM Roger W. Haller, MD CW2 Corry A. Edwards, TX SSG Jeffrey J. Hansen, NE SFC Mark O. Edwards, TN SGT Joshua R. Hanson, MN 2LT Michael I. Edwards, AK SGT Joshua W. Harris, IL SGT Michael Egan, PA SSG Asbury F. Hawn II, TN SGT Christian P. Engeldrum, NY SPC Michael R. Hayes, KY 1LT William E. Emmert, TN CPT Bruce E. Hays, WY SGT Daniel M. Eshbaugh, OK SGT Paul M. Heltzel, LA CPT Phillip T. Esposito, NY SPC Kyle M. Hemauer, VA SPC Michael S. Evans II, LA 1LT Robert L. Henderson II, KY SPC William L. Evans, PA SSG Kenneth Hendrickson, ND SSG Christopher L. Everett, TX SFC John M. Hennen, LA SGT Justin L. Eyerly, OR SGT Gary M. Henry, IN SPC Huey P. Long Fassbender, LA SPC Michael L. Hermanson, ND SGT Gregory D. Fejeran, GU SPC Brett M. Hershey, IN CPT Arthur L. Felder, AR MAJ Tad T. Hervas, MN SGT Robin V. Fell, LA MSG Michael T. Hiester, IN SGT Christopher J. C. Fernandez, GU SGT Stephen C. High, SC SPC William V. Fernandez, PA CPT Raymond D. Hill II, CA SPC Jon P. Fettig, ND SGT Shawn F. Hill, SC SGT Damien T. Ficek, WA SFC Matthew L. Hilton, MI SGT Courtney D. Finch, KS SGT Jeremy M. Hodge, OH SGT Jeremy J. Fischer, NE PFC Derek Holland, PA CPT Michael T. Fiscus, IN SFC Robert L. Hollar Jr., GA SPC David M. Fisher, NY SPC Eric M. Holke, CA SGT Paul F. Fisher, IA SPC James J. Holmes, MN CW3 William T. Flanigan, TN SPC Jeremiah J. Holmes, ME CW3 John M. Flynn, NV SGT Manny Hornedo, NY SSG Tommy I. Folks Jr., TX SPC Chester W. Hosford, MN SGT Joseph A. Ford, IN SGT Jessica M. Housby, IL SGT Joshua A. Ford, NE SPC Robert W. Hoyt, CT SPC Craig S. Frank, MI SPC Jonathan A. Hughes, KY SSG Bobby C. Franklin, GA SGT Buddy J. Hughie, OK 262

SGT Joseph D. Hunt, TN 2LT Scott B. Lundell, UT MSG Julian Ingles Rios, PR SPC Audrey D. Lunsford, MS SSG Henry E. Irizarry, NY PFC Jonathan L. Luscher, PA SPC Benjamin W. Isenberg, OR SPC Derrick J. Lutters, CO SFC Tricia L. Jameson, NE SPC Wai Phyo Lwin, NY SGT Brahim J. Jeffcoat, PA CPT Sean E. Lyerly, TX SPC William Jeffries, IN SGT Stephen R. Maddies, TN MAJ Kevin M. Jenrette, GA SPC Anthony L. Mangano, NY SPC David W. Johnson, OR SSG William F. Manuel, LA SPC Issac L. Johnson, GA SPC Joshua S. Marcum, AR SGT Joshua A. Johnson, VT SPC Jeremy E. Maresh, PA SFC Charles J. Jones, KY PFC Adam L. Marion, NC SSG David R. Jones Sr., GA PV2 Taylor D. Marks, OR SFC Michael D. Jones, ME PFC Ryan A. Martin, OH SGT Ryan D. Jopek, WI Sgt Anthony L. Mason, TX SPC Jeffrey W. Jordan, GA SGT Nicholas C. Mason, VA SGT Anthony N. Kalladeen, NY SGT John R. Massey, AR SPC Alain L. Kamolvathin, NJ SGT Randy J. Matheny, NE SPC Mark J. Kasecky, PA SGT Patrick R. McCaffrey Sr., CA SSG Darrel D. Kasson, AZ SFC Randy D. McCaulley, PA SPC Charles A. Kaufman, WI 1LT Erik S. McCrae, OR SPC James C. Kearney, IA SPC Donald R. McCune, MI SGT Michael J. Kelley, MA SPC Bryan T. McDonough, MN SSG Dale J. Kelly, ME SGT John E. McGee, GA COL Paul M. Kelly, VA SPC Jeremy W. McHalffey, AR SSG Stephen C. Kennedy, TN SFC Joseph A. McKay, NY SSG Ricky A. Kieffer, MI SPC Eric S. McKinley, OR SSG Bradley D. King, IN LTC Michael E. McLaughlin, PA SGT James O. Kinlow, GA SPC Scott P. McLaughlin, VT PFC David M. Kirchoff, IA SGM Jeffrey A. McLochlin, IN SGT Timothy C. Kiser, CA SSG Heath A. McMillan, NY SPC Rhys W. Klasno, CA SSG Michael J. McMullen, MD SPC Chris Kleinwachter, ND SPC Robert A. McNail, MS SGT Floyd G. Knighten Jr., LA MSG Robbie D. McNary, MT SPC Joshua L. Knowles, IA SSG Jeremiah E. McNeal, VA SGT Brent W. Koch, MN SPC Curtis R. Mehrer, ND SSG Lance J. Koenig, ND PV2 Bobby Mejia II, MI SGT Allen D. Kokesh Jr., SD SPC Mark W. Melcher, PA CW3 Patrick W. Kordsmeier, AR SPC Jacob E. Melson, AK SFC Edward C. Kramer, NC SSG Joshua A. Melton, IL SPC Kurt E. Krout, PA SPC Kenneth A. Melton, MO SPC John Kulick, PA SPC Jonathan D. Menke, IN SFC William W. Labadie Jr., AR SSG Chad M. Mercer, GA SGT Joshua S. Ladd, MS SPC Chris S. Merchant, VT SGT Dustin D. Laird, TN SSG Dennis P. Merck, GA SFC Floyd E. Lake, VI SGM Michael C. Mettille, MN SPC Charles R. Lamb, IL SPC Michael G. Mihalakis, CA SPC David E. Lambert, VA SSG Brian K. Miller, IN SGT Denise A. Lannaman, NY SPC John W. Miller, IA SFC Issac S. Lawson, CA SGT Kyle R. Miller, MN CW4 Patrick D. Leach, SC CPT Lowell T. Miller II, MI SGT Terrance D. Lee Sr., MS SPC Marco L. Miller, FL SGT David L. Leimback, SC PFC Mykel F. Miller, AZ PFC Ken W. Leisten, OR SFC Troy L. Miranda, AR SSG Jerome Lemon, SC SGT Ryan J. Montgomery, KY SPC Brian S. Leon Guerrerro, GU SPC Samson A. Mora, GU SPC Timothy J. Lewis, VA SGT Raymundo P. Morales, GA SSG Nathaniel B. Lindsey, OR SGT Carl J. Morgain, PA SGT Jesse M. Lhotka, MN SPC Dennis B. Morgan, NE SSG Victoir P. Lieurance, TN SGT Steve Morin Jr., TX SFC Daniel R. Lightner Jr., PA SGT Shawna M. Morrison, IL SPC Justin W. Linden, OR SPC Clifford L. Moxley, PA SSG Tommy S. Little, AL LTC Charles E. Munier, WY SPC Jeremy Loveless, AL SPC Warren A. Murphy, LA SSG David L. Loyd, TN SGT David J. Murray, LA CPT Ronald G. Luce Jr., NC SPC Nathan W. Nakis, OR CPT Robert Lucero, WY SFC Brian Naseman, OH 263

SPC Creig L. Nelson, LA SSG Christopher L. Robinson, MS SGT Paul C. Neubauer, CA CPL Jeremiah W. Robinson, AZ SPC Joshua M. Neusche, MO SPC Simone A. Robinson, IL SGT Long N. Nguyen, OR SGT Nelson D. Rodriguez Ramirez, MA SPC Paul A. Nicholas, CA SSG Alan L. Rogers, UT SFC Scott E. Nisely, IA SFC Daniel Romero, CO SGT William J. Normandy, VT SGT Brian M. Romines, IL PFC Francis C. Obaji, NY SFC Robert E. Rooney, NH SGT John B. Ogburn III, OR SPC David L. Roustum, NY SGT Nicholas J. Olivier, LA SGT Roger D. Rowe, TN SSG Todd D. Olson, WI CW3 Brady J. Rudolf, OK 1LT Robert C. Oneto-Sikorski, MS SGT David A. Ruhren, VA 1SGT Julio C Ordonez, TX CW4 William Ruth, MD SPC Richard P. Orengo, PR SPC Lyle W. Rymer II, AR SSG Billy Joe Orton, AR SPC Corey J. Rystad, MN SGT Timothy R. Osbey, MS SSG Lukasz D. Saczek, IL SSG Ryan S. Ostrom, PA SFC Rudy A. Salcido, CA SSG Michael C. Ottolini, CA SGT Paul A. Saylor, GA SSG Paul S. Pabla, IN SSG Daniel R. Scheile, CA SGT Mark C. Palmateer, NY SPC Ronald A. Schmidt, KS PFC Kristian E. Parker, LA SFC Richard L. Schild, SD SGT Richard K. Parker, ME SGT Jacob S. Schmuecker, NE SSG Saburant Parker, MS SPC Jeremiah W. Schmunk, WA SGT Lawrence L. Parrish, MO PFC Benjamin C. Schuster, NY SSG Michael C. Parrott, CO SGT Andrew Seabrooks, NY SGT Schulyer B. Patch, OK SPC Dennis L. Sellen, CA SPC Gennaro Pellegrini Jr., PA SGT Bernard L. Sembly, LA SGT Theodore L. Perreault, MA SPC Daniel L. Sesker, IA SSG David S. Perry, CA SGT Jeffrey R. Shaver, WA SGT Jacob L. Pfingsten, MN SGT Kevin Sheehan, VT SSG Joseph E. Phaneuf, CT SGT Ronnie L. Shelley Sr., GA PFC Sammie E. Phillips, KY SGT James A. Sherrill, KY SGT Edward O. Philpot, SC 1LT Andrew C. Shields, SC SGT Ivory L. Phipps, IL SPC Bradley N. Shilling, MI SSG Emanual Pickett, NC PFC Ashley Sietsema, IL CW2 Paul J. Pillen, SD SGT Alfred B. Siler, TN PFC Derek J. Plowman, AR SGT Alfredo B. Silva, CA SGT Foster Pinkston, GA SGT Isiah J. Sinclair, LA SPC Matthew M. Pollini, MA SPC Roshan (Sean) R. Singh, NY SGT Darrin K. Potter, KY SPC Channing G. Singletary, GA SGT Christopher S. Potts, RI SPC Aaron J. Sissel, IA SGT Lynn R. Poulin Sr., ME SSG Bradley J. Skelton, MO SFC Daniel J. Pratt, OH 1LT Brian D. Slavenas, IL SFC James D. Priestap, MI SGT Eric W. Slebodnik, PA 2LT Mark J. Procopio, VT SPC Erich S. Smallwood, AR SGT Joseph E. Proctor, IN SGT Keith Smette, ND SSG Matthew A. Pucino, MD CW4 Bruce A. Smith, IA SPC Robert S. Pugh, MS CPL Darrell L. Smith, IN SFC George A. Pugliese, PA SGT Gerrick D. Smith, IL SSG Thomas D. Rabjohn, AZ SGT Michael A. Smith, AR SPC Joseph A. Rahaim, MS SSG Paul G. Smith, IL SPC Eric U. Ramirez, CA SPC Norman K. Snyder, IN PFC Brandon Ramsey, IL SGT Mike T. Sonoda Jr., CA SPC Christopher J. Ramsey, LA Lt Col Kevin H. Sonnenberg, OH SSG Jose C. Rangel, CA SGT Matthew R. Soper, MI SGT Thomas C. Ray, NC SGT Kampha B. Sourivong, IA SSG Johnathan R. Reed, LA 1LT Jared W. Southworth, IL SSG Aaron T. Reese, OH SFC Theodore A. Spatol, WY SGT Gary L. Reese Jr., TN SFC William C. Spillers, MS SGT Luis R. Reyes, CO SSG Chris N. Staats, TX SPC Jeremy L. Ridlen, IL SPC David S. Stelmat, NH SPC James D. Riekena, WA SGT Patrick D. Stewart, NV SGT Greg N. Riewer, MN SGT Jonnie L. Stiles, CO PFC Hernando Rios, NY SGT Michael J. Stokely, GA SSG Milton Rivera-Vargas, PR Maj Gregory Stone, ID CPL John T. Rivero, FL SPC Samuel D. Stone, WA SSG William T. Robbins, AR MSG John T. Stone, VT 264

SPC Brandon L. Stout, MI SPC Anthony M. K. Vinnedge, OH SPC Chrystal G. Stout, SC SPC Chad J. Vollmer, MI 2LT Matthew R. Stoval, MS PFC Kenneth Gri Vonronn, NY SGT Francis J. Straub Jr., PA SPC Jason E. von Zerneck, NY SGT Matthew F. Straughter, MO SSG Michael S. Voss, NC SGT Scott Stream, IL PFC Brandon J. Wadman, FL SGT Thomas J. Strickland, GA SSG Gregory A. Wagner, SD WO1 Adrian B. Stump, OR SGT Andrew P. Wallace, WI CW4 Milton E. Suggs, LA SGT Daniel W. Wallace, KY SFC Severin W. Summers III, MS PFC Cwislyn K. Walter, HI SSG Daniel A. Suplee, FL SFC Charles H. Warren, GA SSG Michael Sutter, IL 1SG William T. Warren, AR SGT Robert W. Sweeney III, LA SFC Mark C. Warren, OR SPC Christopher M. Talbert, IL SPC Glenn J. Watkins, CA SGT Deforest L. Talbert, WV MSG Davy N. Weaver, GA SFC Linda A. Tarango-Griess, NE SGT Matthew A. Webber, MI SPC Christopher M. Taylor, AL SFC Kyle B. Wehrly, IL SPC Deon L. Taylor, NY SGT Robert M. Weinger, IL CPT Michael V. Taylor, AR SSG David J. Weisenburg, OR SGT Shannon D. Taylor, TN SPC Michael J. Wendling, WI SGT Joshua A. Terando, IL SPC Cody Lee L. Wentz, ND MSG Thomas R. Thigpen Sr., GA SGT Earl D. Werner, WI SGT John F. Thomas, GA SPC Jeffrey M. Wershow, FL MSG Sean M. Thomas, PA SPC James D. Wertish, MN SGT Paul W. Thomason III, TN CPL Michael E. Thompson, OK SGT Marshall A. Westbrook, NM 1LT Jason G. Timmerman, MN SPC Lee A. Wiegand, PA SGT Humberto F. Timoteo, NJ SPC Carlos E. Wilcox IV, MN SPC Eric L. Toth, KY LTC James L. Wiley, OR SSG Robin L. Towns Sr., MD 1LT Charles L. Wilkins III, OH SPC Seth R. Trahan, LA SGT David B. Williams, NC SPC Quoc Binh Tran, CA 2LT Derwin I. Williams, IL SSG Philip L. Travis, GA SPC Michael L. Williams, NY CW4 Chester W. Troxel, AK SFC Christopher R. Willoughby, AL SGT Robert W. Tucker, TN SSG Clinton L. Wisdom, KS SGT Gregory L. Tull, IA SPC Robert A. Wise, FL SPC Nicholas D. Turcotte, MN SPC Michelle M. Witmer, WI 1LT Andre D. Tyson, CA SSG Delmar White, KY SPC Daniel P. Unger, CA SGT Elijah Tai Wah Wong, AZ PFC Wilfredo F. Urbina, NY SPC John E. Wood, KS SGT Michael A. Uvanni, NY SFC Ronald T. Wood, UT 1LT Robert Vallejo II, TX SGT Roy A. Wood, FL SGT Gene Vance Jr., WV SFC William B. Woods Jr., VA SGT Travis A. Vanzoest, ND SSG James Wosika, MN SGT Daniel R. Varnado, MS SPC Brian A. Wright, IL SSG Jason A. Vazquez, IL SGT Thomas G. Wright, MI 1LT Michael W. Vega, CA SGT Joshua V. Youmans, MI SSG David M. Veverka, PA SPC Christopher D. Young, CA 1 American Samoa Chairman INOUYE. Before I call upon General Wyatt, may I recognize Senator Leahy. Senator LEAHY. Thank you, Mr. Chairman. I will hold my time until the questions. But, I just cannot help but note what General McKinley said about Senator Bond. One of the great joys of the last few years here in the Senate has been being cochair with Senator Bond— Governor Bond—on the National Guard Caucus. I have enjoyed our bipartisan cooperation, and that cooperation is one of the reasons why you have four stars on your shoulder, General. You earned them, of course, but we made it possible to have that slot there. Mr. Chairman, I think we have four very good friends sitting up here right now who are on both sides of the aisle. 265 Kit, I know this is going to be your last hearing of this nature before the subcommittee, and I just wanted to say how much I’ve appreciated both the friendship and working with you. Chairman INOUYE. I can’t imagine not hearing from Senator Bond in years to come. Your voice—— Senator BOND. I notice that’s with a smile, Mr. Chairman— you’re not looking sad. Thank you. Chairman INOUYE. May I now call upon General Wyatt. SUMMARY STATEMENT OF LIEUTENANT GENERAL HARRY M. WYATT III General WYATT. Mr. Chairman, Mr. Vice Chairman, Senator Leahy, Senator Bond, on behalf of the 106,700 extraordinary men and women who serve in America’s Air National Guard, thank you for inviting me today, and thank you for the continued strong support that this subcommittee has provided our servicemembers. Many of our folks continue to volunteer at unprecedented rates for worldwide contingencies and to protect our domestic security through air sovereignty alert missions and in responding to natural and manmade disasters. A shining example of the quality of individuals that we have is a young man who is seated behind me. And with the permission of the subcommittee, I would like to introduce to you Staff Ser- geant Kenneth Walker. Sergeant Walker, if you’d please stand. Sergeant Walker is a tactical air control party journeyman. He’s assigned to the 116th Air Support Operations Squadron as a flight supervisor at Camp Murray, Washington. He, in 1998, enlisted in the United States Air Force as an operations resource specialist, and joined the 9th Bomber Squadron in Abilene, Texas. In 2004, he joined the Army National Guard and began training with the 19th Special Forces Group in Buckley, Washington. In 2006, Ser- geant Walker joined the Air National Guard at Camp Murray, Washington, and began his training as a tactical air control party noncommissioned officer (NCO). Sergeant Walker recently returned from his fifth deployment, this time as a tactical air controller personnel, where he directed close air support in support of the 3d Bri- gade Combat Team, 1st Infantry Division, Kunar Province, in Af- ghanistan. On this latest deployment his supported Army unit awarded him with the Army Commendation Medal with Valor De- vice for his successful efforts to save American lives under fire. He led 19 combat air support missions for nine named operations, spent more than 135 hours outside the wire on combat patrol. He successfully prosecuted 18 precision strikes on enemy positions, with more than 48,000 pounds of ordnance on target. His courage and initiative resulted in 33 enemy casualties and an additional 16 enemy-wounded personnel. Sergeant Walker is a traditional guardsman. He is employed for the Oregon Youth Authority, which is a maximum security correc- tional facility for young adults who represent an unacceptable risk to the community. Sergeant Walker is one of the many 106,700 members of the Guard to which we take great pride. 266 It’s interesting that Sergeant Walker will be facing a decision to reenlist, here, pretty soon. In the Air National Guard, he is eligible for a reenlistment bonus, because of the fact that his job specialty is high-operations tempo and is one that is in great demand. He’s entitled to a reenlistment bonus that pays him $15,000, but only if he reenlists for 6 years. Were he on Active Duty, he would quality for a $90,000 bonus and reenlist for 3 years. I say that to point out the need to continue our recruiting and retention budget so that we can continue attracting ladies and gentlemen like this young man. Sergeant WALKER. Thanks. Chairman INOUYE. The subcommittee thanks you and salutes you, Sergeant. General WYATT. In order to ensure our continued success in our State and Federal missions, I’ve identified my enduring priorities for 2010 as, first of all, modernize our warfighting capabilities; second, secure the homefront and defend the Nation; and third, develop adaptable airmen. All equally important. In supporting these priorities, we evolve and shape our force and maintain our outstanding value. Our Nation’s Air National Guard provides a trained, equipped, and ready force, accessible and available—that comprises about one-third of the total force capabilities for less than 7 percent of the total force budget. Mr. Chairman, I’m grateful to be here, and I look forward to answering any questions you and the subcommittee may have of me. Thank you, sir. Chairman INOUYE. I thank you very much. Now may I call upon General Wyatt. SUMMARY STATEMENT OF MAJOR GENERAL RAYMOND W. CARPENTER General CARPENTER. Mr. Chairman, Mr. Vice Chairman, Sen- ators, it’s my pleasure and honor to be here to represent the 360,000 soldiers in the Army National Guard today. And I would like to take a point of privilege and introduce one of those soldiers to you. Sergeant Campbell, would you please stand? He is a Maryland National Guardsman, and he is a senior tactical satellite communications systems specialist. He deployed in 2005–2006 with the 42d Infantry Division, 16th Armored Cavalry Brigade, and was deployed near Kirkuk, in Iraq. In that role, he provided the essential communication link to the warfighter in that area, and had a successful tour there, and returned home. He has been in the Army National Guard for 9 years. That means that he reenlisted about 3 years ago. When I asked him, ‘‘How come he reenlisted in the Army National Guard?’’, he said because he didn’t think he had any other alternative, that that was something that he absolutely wanted to do. And so, I think that it’s important for us to recognize that Ser- geant Campbell represents many of those soldiers who make those decisions on a daily basis, of whether they stay in the National Guard, or not. And to date, our reenlistment rate is over 120 percent, which is a huge kudo to what the soldiers inside of our formations see as, first of all, a patriotic, meaningful service, and something that they want to continue. 267 And so, Sergeant Campbell is in the midst of completing his degree in electrical engineering, and we look forward to his continued service in our Army National Guard. Chairman INOUYE. Sergeant Campbell, we thank you for your service, and we salute you, sir. General CARPENTER. As I mentioned, there are over 360,000 citizen-soldiers in our Army National Guard, as we speak today. And of those 360,000, over 60,000 are either mobilized, deployed, and on point for this Nation. The sacrifice of these soldiers, their families, and employers is something we must not only acknowledge, but certainly appreciate. The National Guard of today is a far cry from the one I joined. The last 8 years have seen the Guard transform to an operational force. The enablers for the Army National Guard, one of the greatest forces for good, in my opinion, have been provided and sustained by the congressional initiatives, many of which we will discuss today. They begin with incentive and soldier programs, support programs, that allow us to recruit and retain the best and the brightest, of which Sergeant Campbell represents. You have supported the resourcing for equipment that has supported the modernization of our fleets inside the Army Guard. We now have equipped our units to 83 percent of critical dual-use equipment, that being the equipment that’s available for use by the Governors as available for use for the overseas mission. Sixty-six percent of that equipment inventory is now on hand, in the States, and available for the Gov- ernors, should they need or have to use it tonight. The National Guard and Reserve equipment account, as General McKinley mentioned, has been especially supportive in our pursuit of equipping the force. Last year, you appropriated almost $800 million for the Army National Guard in that account. And over the last 6 years, you have appropriated almost $5 billion for our use. Thanks to the National Guard/Reserve equipment account, we will retire the M–35, the venerable ‘‘deuce-and-a-half,’’ this coming year. That truck has been in the inventory for almost 40 years, and we will replace them with the new family of modern tactical vehicles. Facilities and infrastructure are especially important in the homeland mission and supporting readiness for the overseas fight. We have 1,400 readiness centers, armories, that are over 50 years old. The President’s budget includes $873 million for construction for the Army National Guard. It is a high water mark in that business, as far as the President’s budget is concerned; something we’d like to see sustained in order for us to do the modernization for those particular armories and readiness centers. I also want to highlight the $30 million appropriated last year in the Guard and Reserve initiative, a military construction NGREA-like account. That appropriation has already made a difference in construction of key facilities that we would not have otherwise been able to build. I solicit your support in the budget for the growth of the non- dual-status technician program. As you may know, those technicians are the ones that do not deploy, because they are not in the National Guard, and they maintain the home fires, they do the pay 268 accounts, the equipment accounts, those kinds of things, in the absence of the dual-status technician. And, as General McKinley mentioned, I would also ask that the O&M accounts presented in the President’s budget be approved, intact. Finally, I would like to acknowledge the support across the Army for the operational force. That support has been demonstrated in the budget process and programming process for the operational National Guard through fiscal year 2014, and it’s actually a great story of the Army team, the Army Guard and the Army Reserve as one team on the battlefield, and one team in the budget process. Again, I’d like to acknowledge the critical role you all have played in building and sustaining the best National Guard in my career, and I look forward to your questions. Chairman INOUYE. I thank you very much, General Carpenter. In recognition of the good work and leadership of the Senate Na- tional Guard Caucus, may I call upon Senator Bond first. Senator BOND. Thank you very much, Mr. Chairman. And thank you, General McKinley, for your very kind words. And, Mr. Chairman and Senator Cochran, it’s been a great honor to work with you, but it’s been a real pleasure to work with my friend Pat Leahy. And when we get something that is of importance to the Guard, I can count on Pat Leahy taking the leadership on his side while I try to do the same on my side. Of all the things I’m going to miss around here, this is one of them. I’d better say something about missing working with my chairman on the Trans- portation/Housing and Urban Development subcommittee, too. But, those things I will miss. But, back to the work at hand. I think we all agree with General McKinley’s statement, and the statement of Generals Wyatt and Carpenter, about the importance of the men and women of our Na- tional Guard and Reserve. And that’s why we were so honored to be able to recognize and thank Sergeant Walker and Sergeant Campbell, on behalf of all the men and women. You truly are, not only a vital component of our Nation’s total force, but you are our heroes for what you do at home and abroad, and we offer you a heartfelt thanks. And now it’s our job, not only to provide the support for you— and I think General Wyatt had a little idea how we might provide a little more support—but also to support, not only the personnel, but the equipment, to make sure that you are able to do the job. And I think one of the greatest achievements of this subcommittee has been its leadership in bringing about significant addition of dual-use equipment. At Katrina, when that hit—I’ve told the story here many times—we sent one of three engineer battalions to Louisiana. They said, ‘‘They’re doing a great job, send another one.’’ I said, ‘‘Well, we’ve had to send ’em in tennis shoes and pickup trucks, because we only have one of our three battalions equipped.’’ But, we have gone from 33 percent to—according to your posture statement—to now 76 percent for the Army Guard. Unfortunately, on the air side, the situation is dire. And I think that we ought to agree that if you call it Air Guard, you ought to have aircraft. Aircraft are a paramount piece of equipment for the Guard to fulfill its mission. But, unfortunately, the Air Force, under pressure from the Pentagon, has been pursuing a strategy 269 that will result in a significant drawdown of Air Guard aircraft. Unless Congress acts, the end result will be the eventual decline of our air dominance and the evisceration of the Guard. And, Senator Leahy, I’ve submitted for the record our letter to Secretary Donley. The Air Force has stated that it is in the midst of modernizing and recapitalizing its weapons systems and that the Air Guard must be concurrently and proportionally recapitalized. But, the problem is, there’s nothing available with which to be concurrent and proportional. And the even greater problem is that they do not seem, still, to be willing to consult with, and talk with, the Air Guard. By the time the F–35 might be ready, we will already have lost multiple Air Guard units. Furthermore, at well over $100 million per plane, according to the Cost Analysis Program Evaluation Of- fice, I’m concerned the F–35 will be too expensive to be procured in sufficient quantities to recapitalize the Air Force and the Air Guard. Now, the Air Force has signaled its willingness to drawn down on the lift capability of the Guard, shifting 12 C–130s from Air Guard bases nationwide to replace older Active component models. The same scheme would also eliminate the only flying unit in the Puerto Rican Air Guard unit. Everyone prays for its response to and support of Haiti. That’s no way to thank them for their selfless service. I refer to this as a backdoor BRAC of the Air National Guard. If the Air Force would leverage further low operating cost, experience, and effectiveness of the Air Guard, then it would have more resources for a much needed recapitalization of the total force. General McKinley, recent reporting indicates that the Air Force fighter gap is smaller than previously identified. I’m concerned about what you think about the total force fighter gap, its impact on the ANT, and how could that fighter gap have been made smaller with a final admission that the Joint Strike Fighter—and I will omit calling it what I normally call it—will slip, and the fact that no new fighters have been purchased in well over a decade. ANG AGING FLEET General MCKINLEY. Senator Bond, obviously, from the facts in your question, equipment is the lifeblood of a military organization—there is no doubt about it. Whether it’s Army, Navy, Air Force, Marine Corps—for our Guard Army and Air Force equipment. And I’ve been before this subcommittee for 4 years; this is my fourth testimony and my first as the Chief of the National Guard Bureau. My perspective is that, on the Air Guard side—and I’ll let General Wyatt comment specifically about what he has done within the Air Force to try to alleviate potential loss of aircraft from some of our units, which actually started in the 2005 BRAC. But, as we all know, by 2011, those BRAC actions must be completed, and therefore, we’re in the process of finalizing what aircraft will move and go to different places. But, it is creating some tension at those home units. The conditions have changed in those 4 years, Senator Bond, in terms of how we plan and program. I would emphasize—and I cer- 270 tainly don’t need to explain to this subcommittee—that the services provide the equipment for the National Guard. The Air National Guard does not purchase aircraft; the aircraft are provided by the United States Air Force. And for over 60 years, there have been enough aircraft to flow or trickle down to the Air National Guard so that they can continue to maintain their units. And we are presently at approximately 88 flying units. We actually have three units that, without any kind of intervention, probably will not have equipment by the end of fiscal year 2012, which is a big concern to all of us, because we know the value of these units, we know the experience of the pilots and the maintenance people; you know those, certainly, better than I do. So, where do we stand? The Air Force and the Department has said that we can reevaluate the amount of flying life left on the legacy fighters. Those are the F–16 and F–15 aircraft. So, if they reevaluate it and extend the life of the aircraft, they can be used longer. They also, obviously, have invested a great deal of capital in the development of the F–35, and their planning assumptions are that they will build more F–35s—go from 48 to 80 per year in their budget—and that’s a significant change over when I first talked to you about what is the Air Guard’s Plan B. So, with that consideration, and the fact that the United States Air Force and the Department has not entertained any 4.5 new aircraft, there’s also a new feature on the table now that would allow for service-life extensions of our Block 40 and 50 aircraft. My concern—and I’ve expressed this to the Chief of Staff of the Air Force—is that most of our units fly the Block 30 F–16. Those are older F–16s that are very capable today, but, without a significant amount of modernization money, will become less relevant and, potentially, less safe to fly over a period of time. So, those are the new dynamics that we face as we work within our services to make sure we reequip the Air National Guard. Senator BOND. Let me add—because I’d like you and General Wyatt to comment on this—the Navy is concerned about the F–35s being ready and available, and even whether they can fly off of carriers. They are looking at purchasing some 4.5 generation. And while they’re talking about a Service Life Extension Program, or SLEP, it costs almost as much as one-half of purchasing a new airplane to get a SLEP, and you have much less capability than one- half the life of a new airplane. And I am curious why, with the tremendous production delays, the performance questions, and the huge cost overrun—which can do nothing but continue to build— there isn’t a consideration of getting the 4.5 or, some would say, the 4.8 generations—15s, 16s, and 18s. And I’d appreciate it if either you or General Wyatt would comment on that. General WYATT. Senator, I would suggest that we now have some information available to us that we didn’t have when we met, 1 year ago, at this time. There have been, obviously, decisions made regarding the F–35 program through RMD 700. We continue to work with the United States Air Force on alternatives and options to address the fighter bathtub, which, unlike last year, we are now in sync with the United States Air Force, as 271 far as how many jets we’re talking about and the risk out over the next few years. As you’re well aware, though, the risk is greater for the Air Na- tional Guard, because Air National Guard has a preponderance of the older airplanes, the F–16 pre-Block 40s, the Block 30s. And so, our problem is near term, especially when we talk about the fact that, of the 18 Air Sovereignty Alert sites around the country, 16 of those are manned by the Air National Guard. And of those 16, 9 and sometimes 10 of those Alert sites are manned by these older Block 30 F–16s. So, it is a primary concern of mine that we address a plan to make sure that we have the capability, in the near term, as we wait for the fielding of the F–35, whenever that may be. We continue to work options with the Air Force, but one of the options that the Air Force is not working, at the current time, is the fourth generation 4.5/4.8. That’s not one of the options that we are considering. That’s not to say that, should circumstances change between now and the next time we have an opportunity to come before this subcommittee, that that might not be a consideration of the Air Force, but, at the current time, that’s not part of the plan. We have offered up and continue working with the Air Force to address this fighter bathtub, considering things such as the previously mentioned Service Life Extension Program. It is expensive. It does extend the life-frame of our Block 30s, if the decision were made to do that, for 41⁄2 to 5 years. But, it, so far, has not been programmed to be done. We’ve talked about the concurrent—and you mentioned it earlier—concurrent and proportional bed-down of the F–35 in the Air National Guard, whenever it is eventually fielded. And there are some reports, that the Air Force is required to file here pretty soon, as a result of NDAA 2010, wherein the Air Force will address, specifically, the question of, What is the intent of the Air Force regarding concurrent and proportional bed-down of fifth-generation aircraft in the Air National Guard? Those reports have not been filed, so I don’t feel at liberty to speculate on what they might say, but would suggest the subcommittee take a look at those when they come in. We’ve talked about a possibility of leveling the squadron size across the combat air forces—Active, Guard, and Reserve—from 24 to 18 aircraft, and flow those legacy airplanes to the Guard, primarily in the form of Block 40 and 50 F–16s, some A–10s, perhaps some F–15Es, that could result in the flow of about 180 jets to the Air National Guard and the Air Force Reserve to address the problem with the age-out of the Block 30s. And we’ve talked about, when the F–35 is eventually fielded, to initially field that in numbers of 18 aircraft, as opposed to 24, so that you can spread the fielding out among all three components, and better service the United States Air Force. We continue to talk about the possible need, because of the delay in getting the F–35 in the inventory, of increased acquisition numbers, from 80 to 110; an expensive proposition, as you have previously pointed out. 272 We also look at transitioning some of these fighter units to remotely piloted aircraft, and then maybe some other nonflying missions. But, in the end, we face that latter circumstance. Senator BOND. Well, General, I don’t want to impose any more. I have one followup question on that. Maybe I’m getting old and cynical, but to think that the Air Guard is going to get the Joint Strike Fighter when that comes off the line—whenever it comes off the line—at the same time the Actives get it, is something I just— I am from the Show Me State, and I will only believe it when I see it—when, very shortly, 80 percent of the Guard’s F–16s will hit the end of their service life. What will the total shortfall be that would have to be filled in with SLEPs of the existing Block 30s, with whatever is left over from the Active Air Force; 15s, 16s, F–4s, Cessnas, or whatever it is that they’re going to fill it in with? What’s the total number in that bathtub, before you start looking at all the options you have to pursue? General MCKINLEY. Senator Bond, I asked that of the Air Force today. And outside this future years defense programs (FYDP), the Air Force is predicting 135 aircraft, a gap. That’s outside the 2012– 17 FYDP. That’s from the United States Air Force. Senator BOND. All right. General MCKINLEY. But, for the Air National Guard, as I look at our portfolio, closest wolf to the sled right now, we have about 10 Block 30 F–16 units. Those are the ones that will require attention the quickest, and will require General Wyatt, in the United States Air Force, to come up with a solution to either extend the life of those airplanes, to keep them flying longer, if it’s relevant and safe—I’m very concerned about the safety of the aircrew in these older legacy fighters—or, we have to find alternative missions. Be- cause the last thing that I want to see is a wing of aircraft leave, and leave 1,200 people at a location with nothing to do. That’s just not in the interest of the American citizen. Senator BOND. Finally, the number of Block 30s in those 10 units, what is the number of airplanes that—and do you know the date—the service-life date range when they would be past service? General WYATT. Yes, sir. Most of our Air National Guard wings are 18 aircraft, so those 10 wings would equate to that 180 airplanes. And we are now in sync with the Air Force on the esti- mations of when the service life will expire, and we’re looking at somewhere right around the 2017 timeframe when most of those Block 30s will hit the age out. Now, some will age out a little bit before then, and some will age out a little bit after that. But, as far as combat capability in a squadron-size formation, we’re looking at about 10 wings. Senator BOND. Thank you very much. And, Mr. Chairman, I apologize, I have a bunch more questions I’ll submit for the record, but I thank you very much for your kind- ness. Chairman INOUYE. Thank you. Senator Leahy. NATIONAL GUARD EQUIPMENT Senator LEAHY. Well, thank you. 273 And, again, I thank Senator Bond for his work all these years on the National Guard Caucus. I must say, Kit, as I’ve told you before, it was very helpful to have someone beside me who was a former Governor because you brought a perspective which was very, very helpful. General McKinley, it is nice to see you here, as always. I’ve enjoyed the times you’ve visited us in Vermont. And I’ve enjoyed being here with you. I was very proud to be there the day you were awarded your fourth star, and to be there with your family; a very nice family, I might add. What I worry about is how the Army and Air Guard still fall short of the equipment and the aircraft they need. I’ve introduced legislation, along with Senator Bond, to establish a dedicated budget line for the Army and the Air National Guard. Would you agree we ought to do that? General MCKINLEY. In my opening comments, Senator Leahy, I said that we really do depend on our services for our equipment and our operations and maintenance, as do the other Reserve Chiefs; there’s no doubt about it. And it’s tough engagement, and as we build a budget, to convince the Air Force and the Army of our needs. I especially have found, since I’ve become the Chief of the National Guard Bureau, that many of our domestic requirements fall below the lines, quite frankly, on many of our Active Duty budgets, simply because there’s not enough investment capital to take care of both the home game and away. My bottom line, sir, is, through the support of committees like this, we’ve been able to mitigate the effects of loss of purchasing power and equipage through the budgetary process. If it gets tighter, which everybody forecasts it to be over the next 3 to 5 years, with budgetary pressure, I’m afraid that both my colleagues on left and right are going to find it more difficult to equip the units in the fashion that they need to sustain the capability of both Army and Air Guard units. What that leads us to, Senator Leahy—I’ve got to tell you, I’ve got to stay within the Department bounds, here, but we will run into a budgetary crisis in reequipping the National Guard as soon as the budgetary pressure starts to set in. And, as you could tell from Senator Bond’s question, we may already be there with the Air National Guard. Senator LEAHY. Of course, Senator Bond and I have the privilege of not being within departmental guidelines and we can do what we want to do. We answer to the voters in our own State. I’m not trying to set up a conflict between the Guard and the Regular Army or Air Force. I just want less time to be spent on conflicts inside the Pentagon and more time spent concentrating on your mission. Senator Bond mentioned people calling for help, in Katrina and elsewhere. You’re forced to reply, ‘‘We’re happy to send help, but all our equipment is overseas.’’ I think there has to be—you understand this—a balance here. We’re all aware of the number of people from all of the State Guards that are overseas, either in Iraq or Afghanistan. We have the largest deployment of the Vermont Guard that we’ve had since World War II. I mean, this is very, very significant—thousands of people from a little State like ours. We’re 274 very proud of all these men and women. They have been extraordinarily well trained. When I go to Iraq or Afghanistan, and I talk to the commanders on the field, they make no differentiation between the Guard and the Regular Army or Air Force today, because they’re all integrated, they’re all working together. And many times, I know, when I’ve gone from one part of the theater to the other, I’m very often on a Guard plane or helicopter. General Carpenter, you’d be proud of the pilots that you have flying those helicopters. But the problems at home continue just the same. God forbid that we have another major earthquake on the west coast, but we remember what happened when the major one that struck Cali- fornia. Had it not been for the Guard, that disaster could have been even worse than it was. Or what happens in wildfires, what happens in rescue missions, what happens in floods, and the whole litany? We know that the Guard is not just homeland security. And we know that, in all likelihood, they’re going to be called up to go overseas more in the future. We have got to find a way to get both into the budget. General Carpenter, I mentioned the Army Guard equipment shortfall. The situation has improved, but I believe the Guard’s at only 77 percent of equipment levels. Does the fiscal year 2011 budget request more? Where are we going to be over the next couple of years? General CARPENTER. Sir, as I mentioned in my opening statement, the equipment that we have coming to the Army National Guard is unprecedented. The modernization piece, as I mentioned, is going to allow us to retire the venerable ‘‘deuce-and-a-half,’’ this next year. And we retired the UH–1 helicopter, here, this past year. And so, a couple of years ago, we started into this process of transparency. Prior to that point, all we saw was the dollars that got appropriated, and we were guessing, or hoping, that the equipment came out the other end and showed up in the vehicle storage areas. The Army and the Army Guard and the Army Reserve have made great progress in that, to the point where I think we can give you pretty much an 80-percent affirmative that what you appropriate in Congress for the Guard, as far as equipment is concerned, is going to show up, with a time lag, obviously, inside the Army National Guard. If the promises made to keep the Army National Guard as an operational force are carried out through the next POM, the program objective memorandum, we’ll continue to improve, sir. But, as General McKinley mentioned, the issue here is going to be pressure on the budget. And as those pressures come to bear, those POM dollars, those projected programs, are likely to change; and our concern, obviously is, is that it’s a proportional change between the Army Guard and the Army. And I guess that’s something yet to be seen. Senator LEAHY. I think perhaps you and I should talk further about this later on, but I am concerned. 275

C–130 And, Mr. Chairman, my last question is about a letter that Sen- ator Bond and I sent this morning to Secretary Donley. I address this question to General McKinley. We asked Secretary Donley to reconsider the decision to move C–130 airframes out of the Air Na- tional Guard into the Active component. Of course, I have not yet heard back from him. I’m not asking you to indicate what he might say, but I worry that we are robbing Peter to pay Paul. It seemed like the Air Force, while they said they were studying the C–130 issue, offered the fiscal year 2011 budget that went ahead and cut Air Guard C–130 force structure. I hear that military airlift throughout the world is stretched to the maximum. Certainly, I hear that message when I go to other parts of the world. Were you consulted by the Air Force leadership before the decision was made to draw down the Air Guard C–130 force structure? And, if so, what did you recommend? General MCKINLEY. I personally was not consulted. I have brought the matter to the Chief of Staff of the Air Force’s attention, and he was very willing to discuss it with me. He, in turn, has asked his staff to revisit this issue. Not only did it affect our Air National Guard C–130s, General Stenner and some of his Air Force Reserve C–130s were included, too. And, Senator Leahy, as I said in my opening remarks, some of this is post-BRAC movement of aircraft. But, the analysis and the assumptions made to reduce the C–130Es, the oldest of our Air Force C–130s, has led some to believe, in the Air Force, from what I understand after I’ve talked to General Wyatt, that those aircraft need to be retired, that funds need to be used for other purposes. I certainly want to work with the United States Air Force to make sure that the analysis and the assumptions that they drew, which were part of a mobility capabilities requirements study (MCRS) for mobility aircraft, which included all of our lift aircraft, was done with the appropriate considerations to protecting of our homeland, for supporting our Army in direct support mission. And so, I’m asking the Chief of Staff to take a look at this slide deck. Senator LEAHY. Well, I’m going to be very interested in hearing the response. I’ve been on more C–130s than I’d like to think about. As one pilot told me, ‘‘It’s the only aircraft pressurized to keep this noise inside.’’ I can see some nodding heads in the back. I’ve been on these in all parts of the world; in fact, even once with Chairman Inouye. And virtually every time, they are being flown by a Guard unit. So, I’ll be anxious to hear the response from the Secretary. And you and I will probably discuss this further. Thank you for your courtesy, Mr. Chairman, in giving me this time. Chairman INOUYE. Thank you very much. SUICIDE General Carpenter, I will be submitting questions on the upgrade of Blackhawks and your shortfall on equipment. But, may I ask one question? Last year, your suicide rates went up 75 percent. And you have responded to that. Is the program sufficient? 276

General CARPENTER. Sir, we are alarmed by the suicide rates we’re seeing inside the Army National Guard, also. January was the highest ever, in terms of the number of suicide rates we’ve experienced; above last year. That declined in February, to the point where currently we have experienced 24 suspected suicides in fiscal year 2010, against a number of 22 last year. Senator Brownback, I think, is probably very familiar with the initiatives that are being made by Kansas and the adjutant general of Kansas, in terms of the resiliency program. In addition to that, the Army at large is seriously engaged with the Vice Chief of Staff of the Army, in terms of dealing with the suicide rates. Obviously, this is for the most part, a function of stress on our forces. Although in the Army Guard we have a little bit of an anomaly, because you find that almost one-half of the suicides we’re experiencing are from soldiers who haven’t even deployed. And so, there’s more to this than just the mobilization and deployment piece. But, the issue—the bottom line issue, as the Army has viewed it—and I agree with them, and I think most do—is, it is preparing people for situations that are almost overwhelming, in many cases. And we see that in our young people. We see that inside our soldiers. We see that in the families. And so, we’ve got to build a resiliency out there to be able to sustain those tough times and to be able to not look at suicide as a viable option. And so, we are engaged with the Army on their Soldier Fitness Program. We are engaged with Kansas and General Bunting, in terms of the Flash Forward Program. And, frankly, we are trying to gather all the resources we can find to come to bear on this problem. And it’s very serious. General MCKINLEY. Senator Inouye, I’d like to thank General Casey and General Chiarelli for doing so much in the United States Army to address this situation. I’d also like to thank the State of Kansas for partnering. These types of programs are essential so that we can continue to take care of deploying airmen and soldiers. I think all of us are very concerned about the rapid rise in suicide and attempted suicide. And only through resiliency dollars—and thanks to this subcommittee for realizing that these programs require money to be successful—have we been able to get our arms around this very, very serious problem. Chairman INOUYE. Thank you very much. Senator Cochran. Senator COCHRAN. Mr. Chairman. I am curious to know, General Carpenter, about the transition that is taking place into making the Army not just a National Guard force with traditional responsibilities, but actually an operational force, ready to go to the field—possibly combat right away. How well is the Army National Guard adjusting, in your opinion, to this transition? Is it too much for you to handle? Should we take another look at this and maybe take a step back and modify what we’re trying to do? What’s your assessment of the success of this? General CARPENTER. Sir, as I mentioned in my opening statement, the National Guard that we have right now is far different from the one I joined, you know, a lot of years ago. And as we went into the—what was then the global war on terrorism, after 9/11, we 277 had soldiers who had joined the Army National Guard, not expecting to be deployed. And those great soldiers deployed, some of them being from the 155th, and they went and did their duty, and they were proud of what they had done. They came back home, and they came to grips with the idea that maybe that wasn’t quite what they had in mind, didn’t fit into their lifestyle; their employers and their families said, ‘‘You know, this isn’t quite what we signed up for,’’ and they made decisions to leave our formations. And that caused the recruiting crisis we saw in the Army National Guard in 2005. And General Vaughn, my predecessor, was key in turning that around. Since that time, we have had a different look at how we recruit people into the Army National Guard. The people we recruit in to our formations now, as was mentioned, are expecting to deploy. It’s not if they’re going to deploy, it is when they’re going to deploy. And they have come to grips with that idea. And I think that, for the most part, we have an Army National Guard that is, at least in terms of mindset, an operational organization. What we’ve got to do is, we’ve got to make sure that we provide the enablers, the resourcing, for those young soldiers to go out and do what they’re supposed to do. OPERATIONAL FORCE Operational, at least in my definition, is manning the force, equipping the force, and then training the force, and then, finally, having access to that force. And the access discussion is one we have regularly in the Pentagon. But, my response is that we are exceeding the recruiting goals, we are exceeding the retention goals. We are stressed, we are sending soldiers more frequently than what we would like. But, frankly, sir, I’ve got to tell you, we are doing very well in this operational force. General Campbell, who’s the FORSCOM Commander, his comment on the operational National Guard and operational Reserve is that it is a national treasure, one which we abandon at our own peril. So, sir, the enablers, I think, are the key piece. Senator COCHRAN. Well, that’s very impressive, and we appreciate your leadership in helping achieve these results. General Wyatt, I was going to ask you the same question. What’s your response? General WYATT. Senator, the way the Air Force has used its Re- serve component since about 1990 has been as an operational force. And we have been fortunate to enjoy the support of the United States Air Force in making sure that we train to the same standards, have the opportunities to deploy. And our deployment record speaks for itself. We are accessible, we are available. And again, the Air Guard is kind of like the Army National Guard; not the Air Guard that I joined, back in 1977. We’ve come a long way. But, in spite of the operations tempo, we continue to man our force at over 100 percent of our end strength. As we speak today, I believe our numbers are about 1,400 airmen over end strength, gradually coming back down to our target. But, our retention rate has exceeded the requirements. We have the highest re- 278 tention rate of any of the Reserve components, at close to 91 percent. People want to join our formations, and they want to stay in our formations. Our concern continues to be the modernization of our equipment to make sure that we provide the combat capability that this country needs in the Reserve component. Similar challenges that, I’m sure, General Stenner faces with the Air Force Reserve. But, we continue to work those issues with the Air Force. In those areas where we need some additional help with our modernization, both for the warfight and for the domestic mission overseas, this subcommittee has been extremely supportive with the NGREA accounts, and it keeps us relevant and in the fight. We do have this issue that Senator Bond has brought to the attention of the subcommittee today. We continue to work through that. But, it is a resilient force, continues to be available anytime we’re called, and readily accessible. Senator COCHRAN. Well, we appreciate your leadership very much. Thank you for your service. Chairman INOUYE. Thank you. Senator Murray. Senator MURRAY. Thank you very much, Mr. Chairman. And thank you, to all of you, for the service that you provide and for the tremendous work you’re doing and all those who stand behind you. And I especially want to recognize Staff Sergeant Kenneth Walk- er, behind you there. I wasn’t here when you were introduced earlier, because I was at a Veterans Affairs Committee hearing. But, we’re delighted you’re at Camp Murray, and know it’s a great place, and appreciate all your service to our country. So, welcome to you. I wanted to ask, today—we all know the economy is really struggling, and our folks are coming home from Iraq and Afghanistan to a lot of hardships that make it extremely difficult for them. In the State of Washington, our National Guard unemployment is over 14 percent, versus what our State is, at 91⁄2 percent unemployment. And in the last 3 years—Senator Inouye asked about the issue of suicide—we’ve seen seven suicides, with five of those tied to the guardsmen’s financial situation. Twenty-one hundred Wash- ington National Guardsmen live at or below the poverty line, as a result of employment when they come home. And I am really concerned, and increasingly concerned, about our soldiers’ mental and emotional well-being as they return home from their service into the financial instability that their families are facing, and wanted to ask all of you what the National Guard is doing, really across the country, to help these National Guard soldiers, and their families, when they return home from deployment to this financial hardship they’re facing today. General MCKINLEY. Senator Murray, thank you for your question. And I just returned from Washington State, had a great briefing from the adjutant general, Tom Lowenberg, about these very serious concerns that he has. I will tell you that our deploying soldiers and airmen are facing challenges that none of us, on this panel certainly, ever did in our military careers. The stresses, the strains, the financial difficulties, the times we live in, the stress on 279 the family, the fact that we’ve had continuous rotations, obviously have created an environment where many of our young soldiers and airmen struggle to make ends meet. General Carpenter has got several programs he would like to cover with this, but I would like to say that we benchmarked off some of the other Reserve component forces. General Stultz, who will follow us, has done some outstanding work with the Army Re- serve in trying to address those needs. But, Ray, if you’ll cover the Army Guard, and, Bud, what you’ve done on the Air side, please. FAMILIES General CARPENTER. First of all, I know you know the 81st Bri- gade from Washington is back home, and they probably—— Senator MURRAY. Yeah. General CARPENTER [continuing]. Are exactly the population you’re talking about, in terms of what they’re experiencing, in terms of coming back off from a mobilization, and the job market that they face. As we looked at it—you are exactly on point, Senator—the unemployment rate for the Army National Guardsmen who come back is about 3 points above what we expect. As General McKinley mentioned, we have partnered with General Stultz in a number of initiatives; ‘‘Helmets to Hardhats,’’ for instance, is one that he has championed. He has also, and we have across the States, signed employment partnerships with Indiana, Chicago, California. And the whole effort, here, is to find guardsmen and reservists who are in exactly the plight that you’ve just described, and find a way for them to find a job and again return to some sort of meaningful lifestyle after deployment. It’s not easy, and, frankly, the economic times have presented even a larger challenge than we had 3 or 4 years ago. But, that doesn’t mean we shouldn’t start into it and get about this business. Beyond that, we have a significant number of soldiers who are on what we call ADOS, additional duty operational support, which puts them on orders to support other units that are mobilizing and deploying. And with the qualifications of the soldiers you have in Washington, to the extent that they’re willing to be part of that program, there are some opportunities there. Taking care of the soldiers is the Yellow Ribbon Program, which I know you’re very familiar with. The State of Washington, and General Lowenberg and his staff out there, have done great work, in terms of getting to those soldiers and families that need help, that deserve the help. As I say, there’s more to this war than just crossing the berm for Baghdad. We have soldiers who deserve care, and absolutely are entitled to the care, after they come home. And whether it happens to be emotional issues or whether it happens to be job issues—— Senator MURRAY. Well, and we’re redeploying them again. And are you concerned about the readiness factor, if they come home, they’re unemployed, their families are in financial hardships, they get called up again? How’s readiness—— General CARPENTER. Absolutely. 280

Senator MURRAY [continuing]. Affected? General CARPENTER. Eighty percent of our force is what we call a traditional Guard force. That means that they have an employer out there—they’re doing something else besides being full-time in the National Guard. And if we didn’t have the employer support that we’ve got out there today, we wouldn’t have a National Guard. So, we are very mindful of that. And it is a readiness issue. Unlike the—our Active component counterparts, we have to have that support for us to be able to sustain and for us to ask the soldiers in the 81st Brigade to go back again. Senator MURRAY. Yeah. General Wyatt. General WYATT. Senator Murray, we continue to leverage the strengths and the best practices, as General McKinley’s indicated, from some of our brothers and sisters in the Reserve component. We enjoy the opportunity to partner with the Army National Guard, through the leadership of the adjutants general in the respective States, territories, and the District of Columbia, to leverage those resources that the Army National Guard provides, and then those that the Air National Guard provides. We have, at each of our wings—we are a wingcentric organization, and our outreach to our airmen is primarily through the wing leadership, obviously under the supervision and direction and command of the adjutant general. But, we have a wing—wing family support coordinators at each of our 88 wing locations. In addition to that, we’re in the process of contracting for what we call behavioral health professionals that will address the mental health issues that you talked about just a few moments ago. These individuals will be provided to the adjutants general to be placed within their States, at his or her direction. They are also available to service the needs of any of the other Reserve components who may happen to be within the boundaries of that State. It’s not just exclusively a service provided to the National Guard; it is made available to all members of the military. We are also embarking upon a process to make sure that the available resources out there are efficiently used and that the communication with our individual wing members is such that they know the programs are there, they know the avenues through which they can access those programs, whether they be provided by the National Guard, Army Reserve, Air Force Reserve, or Active Duty. And we are working with the Active Duty to strengthen the access to Active Duty programs that usually surface at Active Duty bases, but also being made available to our Air Force, Reserve, and Guardsmen. Senator MURRAY. Okay. I think we really need to focus on this, because I do believe it’s a readiness issue, and I see those families struggling, and it’s a tough time for everybody. HEALTH ASSESSMENTS General McKinley, it’s my understanding that some of the returning National Guard members are not honest on their postdeployment health assessments, simply because they don’t want to be delayed going home. Totally understandable. I wanted to ask you if it would be beneficial to require the postdeployment 281 health assessment at their home station instead of the demobilization site, to make sure that they can get assistance at home, in order to properly assess their mental health status. General MCKINLEY. Ma’am, I think anything that we can do to help soldiers return home quickly, get back into their normal life cycle, and then give them the care that they need and deserve from their deployment, would be helpful. General Carpenter, have you heard that the Army is looking at doing any of this? General CARPENTER. We have a ongoing study with the Army right now. Retired General Franks is looking at the Medical Eval- uation Board process, something that hasn’t been looked at for almost 30 years inside the Reserve component. Part of that has to do with how we handle soldiers as they go through the demobilization process. And you are, again, absolutely right on the money, Senator, in terms of the people who want to get home and be with their families, as opposed to spend time at whatever installation they’re being—— Senator MURRAY. And they’re afraid—— General CARPENTER [continuing]. Processed—— Senator MURRAY. And I hear it all the time, they’re afraid to say something is wrong, because they don’t want to sit there, miles and thousands of miles away from family. So—— General CARPENTER. Yes, Senator. And the initiative that’s being considered, at this point, is for the soldier to be honest with whatever emotional or physical problems they might have, be allowed to go home, be with their families, and then allow them to return to get the necessary treatment, whether it happens to be at the installation or whether it happens to be elsewhere. Because if they don’t do that, and somehow or other we have to treat them through other programs, they are disadvantaged, in terms of the benefits that they get. And so, we in the Army Guard, and in conjunction with the Army, are looking at that and trying—— Senator MURRAY. Okay. General CARPENTER [continuing]. To use that perhaps—— Senator MURRAY. I think that’s—— General CARPENTER [continuing]. As a solution. Senator MURRAY [continuing]. Important to do. I mean, I understand how much easier it is to keep track of people at one place, but readiness is an issue, again. And if we don’t get them home and with their families, and get them the care they need, then we’re going to be in trouble in the future, and certainly they are. General MCKINLEY. Ma’am, I’ll bring it up with General Casey when I see him later today. Senator MURRAY. Okay, very good. Finally, my last quick question. In the State of Washington, we’re very interested in adding a Stryker Brigade Combat Team to the Army National Guard, and wanted to ask you how an additional Stryker brigade would be beneficial to the Army National Guard. General MCKINLEY. Well, we certainly had great success with our Pennsylvania Stryker formation that went over to Iraq. We’re very pleased at the results. Obviously, again, Ma’am, General Casey and his leadership team, in concert with the leadership team 282 of the Army National Guard, working with the Governors and working with the States, will decide the future acquisition strategy of Stryker. But, if you’re asking our personal opinion, I think, representing the organization in a whole, we would welcome the opportunity to see additional Stryker brigades in the National Guard. And I’m sure my counterparts behind me would agree, too. It’s a great, great platform, that we have found works extremely successfully in the combat theater, and we think it has applications here at home, also. Senator MURRAY. Okay, very good, thank you. And thank you, again, to all of you. Thank you, Mr. Chairman. Chairman INOUYE. Thank you very much. ADDITIONAL COMMITTEE QUESTIONS And, gentlemen, I thank you very much for the testimony this morning. And we’re grateful for your service to our Nation, and, through you, may we thank the men and women of your command for their service to our Nation. We appreciate it very much. [The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

QUESTIONS SUBMITTED TO GENERAL CRAIG R. MCKINLEY

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

ARMY AND AIR GUARD—EQUIPMENT Question. General McKinley, the equipment levels of the Army and Air Guard have improved significantly in the last 3 years, in large part due to additional equipment funding provided by Congress. The Army Guard now has 77 percent of its equipment requirements, up from 40 percent in fiscal year 2006. Do you believe that the Army and Air Force have adequately budgeted for Guard equipment requirements through the remainder of the future year defense plan? Answer. The Army National Guard (ARNG) believes $3.5 billion to $4.5 billion is required each year of the future year defense plan to sustain at its current operational capability as an operational reserve. The current funding profile has a steady decline starting in fiscal year 2009 through fiscal year 2011. Additional funding is required to increase the modernization level to maintain not only modernization parody with the Active Component, but also to sustain and improve existing equipping interoperability. Between fiscal year 2006 and fiscal year 2010, Headquarters Department of the Army invested approximately $29 billion in funding for procurement and modernization of ARNG equipment. While overall growth in equipment readiness and Equip- ment on Hand increases have been modest during this period, the ARNG’s ability to respond to domestic incidents has increased dramatically. Equipment on Hand levels for Critical Dual Use items improved from 66 percent in fiscal year 2007 to 84 percent by the end of fiscal year 2009. Furthermore, the ARNG is projected to reach 87 percent of Critical Dual Use Equipment on Hand by fiscal year 2011. The Air Force continues to budget the Air National Guard as an operational force; however, the modernization and recapitalization challenges the Air Force is facing continues to affect equipment readiness across all components. We are working with the Air Force and its major commands to find solutions to recapitalization of the ANG’s equipment used in domestic and overseas contingency operations. Equipment readiness presents greater challenges as long-term costs in operating and maintaining older aircraft continue to rise due to more frequent repairs, fluctuations in fuel prices, and manpower requirements. The cost of aircraft maintenance continues to rise significantly as we struggle to extend the life of our aging fleet. This infrastructure of equipment is not just fighters; it includes tankers, air traffic control, com- 283 mand and control, security, and, communications—the entire system supporting and protecting our nation’s last line of defense. Question. General McKinley, what remaining equipment shortfalls are you most concerned about? Answer. The majority of the Army National Guard (ARNG) equipping shortfalls exist in modernization of Aviation platforms, Force Protection, Communication and Transportation equipment. Specifically the ARNG is concerned with the modernization of UH–60A to UH–60L models, the Medium Truck fleet, High Mobility Multi- purpose Wheeled Vehicles (or HMMWVs), Chemical Protection Shelters, and High Frequency Radios. Modernization of UH–60A to UH–60L models.—While the ARNG currently has sufficient quantities of UH–60 aircraft on hand, much of the fleet needs modernization. Failure to upgrade or replace these aircraft at a rate that outpaces obsolescence will degrade the ARNG’s domestic and war fighting mission capabilities. The current UH–60 A–A–L program production rate is less than the established HQDA rate. This reduced production exacerbates the effort to modernize the existing UH– 60 fleet. Medium Truck Fleet.—The ARNG has an fiscal year 2016 Family Medium Tac- tical Vehicle (FMTV) requirement of 31,568 Medium Trucks with 24,417 on-hand and only 12,009 of the 24,417 are modern. The ARNG is on path to divest all existing M800 Series Trucks by fiscal year 2012. Our legacy M939 Medium Tactical vehicles are projected to remain in the ARNG’s inventory until fiscal year 2025. These M939 Series vehicles have an average age of 23 years and are becoming more difficult to sustain. The current Presidential budget for fiscal year 2011 will produce an additional 9,000 FMTVs and increase our modernization to 63 percent. HMMWVs.—The ARNG has a fiscal year 2016 requirement for 44,286 HMMWVs. After all new programmed procurement and Recapped assets are delivered to existing inventory, the ARNG will have 100 percent of the HMMWV requirement. After new production ends, the ARNG will still have legacy HMMWVs in the inventory that are in excess of 20 years old. It is estimated that 12,127 legacy HMMWVs will require Recapitalization before the end of their use. The programmed Recap program will update 7,800 HMMWVs and will leave a shortfall of over 4,000 vehicles requiring a Recapitalization. Chemical Biological Protective Shelter System (CBPSS).—The ARNG has a fiscal year 2016 requirement for 291 systems. CBPSS is on contract with First Article Testing being conducted in May 2010 through March 2011. Pending success, full production is projected to begin in the second quarter of fiscal year 2011. High Frequency Radios.—The ARNG has a fiscal year 2016 requirement for 559 Global Broadcast System (GBS)/Receiver Suite: AN/TSR–8 Satellite Communica- tions Systems, with 35 on-hand. With projected fiscal year 2011 deliveries, the ARNG will have a shortfall of 515 Global Broadcast System. The Air National Guard continues to face challenges within the Domestic Re- sponse framework with equipping Security Forces, command and control personnel, imagery analysts, engineers and medical personnel. There is a need for tactical vehicles for Security Forces to provide enhanced capability to conduct operations such as checkpoints, road closures, traffic control points, civil disturbance operations, town patrol, and similar ‘‘on the street’’ missions. Our security forces require weapons and accessories, upgraded mobility bags and enhanced security and traffic control kits. Direct imagery analysis suites or needed to provide direct imagery analysis support to first responders. Additional CBRNE Enhanced Response Force Packages are critical to support the Homeland Response Force teams. Explosive Ordnance Disposal (EOD) equipment is required by 17 ANG units to respond to hazardous chemical, biological, radiological, and nuclear incidents throughout the United States and abroad. We have a need for deployable power teams during disaster relief operations to provide stable power support, advice and technical assistance in all aspects of emergency electrical power and distribution systems. Other top equipment needs critical to Domestic Support are Disaster Relief Bed-down Sets, and Mo- bile Short Range Command and Control equipment.

FAMILY SUPPORT AND YELLOW RIBBON PROGRAMS Question. General McKinley, one of the greatest priorities of this Committee is to ensure that service members and their families receive the support services they need. This is especially true for the families of the nearly 725,000 Guard and Re- serve members that have been activated since September, 2001. Outreach efforts such as the Yellow Ribbon Reintegration Program are particularly important for guardsmen and families who are geographically dispersed across the country. Are 284 family support programs fully funded in the fiscal year 2011 budget request? Are there programs, from your perspective, that could be improved? Answer. The National Guard Family Program is currently fully funded based on our fiscal year 2011 budget request. The National Guard Bureau continues to work through the Army and Air National Guard branches to ensure we are achieving maximum efficiencies from our funding. While we believe our Family Program does a very good job, we are always striving to do better. The continued support of Con- gress is greatly appreciated and will ensure our future success. Question. Gentlemen, the Yellow Ribbon Reintegration Program was established to provide outreach services and to support the members and families of the Na- tional Guard and Reserve. Can you please comment on the reintegration efforts for your component and whether or not your needs are being met? Answer. The National Guard has done a tremendous job ensuring that our service members and their Families are receiving the benefits of the Yellow Ribbon Re- integration Program (YRRP). From October 1, 2009 to September 4, 2010 the Na- tional Guard has hosted 1,298 events and activities in 270 different locations. These events and activities have supported 96,276 Army National Guard service members, 3,470 Air National Guard Service members, and 401 service members from other Reserve components. Additionally, 56,297 spouses, 9,446 parents, and 21,391 child/ youth have been supported through the National Guard Yellow Ribbon Reintegra- tion Program during this period. As you can see from the statistics provided the National Guard has a robust Yel- low Ribbon Reintegration Program. We are learning however, that in keeping with the intent of the YRRP legislation that we may potentially be providing the education, assistance, and resource information through the YRRP process too early and possibly for not nearly long enough. Feedback from our Commanders, program managers at the State level, and even some attendees at YRRP events and activities indicates that some of the major issues that are addressed as part of the YRRP process (psychological and physical issues, substance abuse, and possible suicide ide- ology, to name a few) do not actually manifest themselves until long after the Serv- ice member has attended their last YRRP event, which is currently the 90-day post deployment event.

QUESTIONS SUBMITTED BY SENATOR DIANNE FEINSTEIN

MILITARY CONSTRUCTION Question. Can you explain how the National Guard Bureau prioritizes its military construction projects both in a current budget year and in the Future Years Defense Plan? Answer. This process starts with the submission by each of the 54 States/Terri- tories and the District of Columbia of prioritized lists of major military construction (Milcon) projects. Projects with Regional or National significance are included in the list. The projects are ranked against each other according to established criteria related to project characteristics. Those criteria are the following: Support of force modernization; joint use project; resolves existing health and safety or environmental problem; equitable distribution of projects (funding not received in previous years); replacement of facilities in poor condition; the Adjutant General (TAG) priority rating. The criteria are reviewed annually based on National Guard Bureau priorities. The Army and Air National Guard projects compete with other Army and Air Force Projects for funding. Entry into the Future Years Defense Plan, (FYDP), is the goal of the Infrastructure Requirements Plan and the amount of funding provided from the Army and Air Force. Question. What direction do you provide to State Guard Bureaus as they prepare their lists of priorities? Answer. Each year the States receive a guidance memo from the National Guard Bureau (NGB) along with any updates to our regulation on program development. The criteria are reviewed annually considering Army and NGB priorities. Those criteria are the following: Support of force modernization; joint use project; resolves existing health and safety or environmental problem; equitable distribution of projects; replacement of facilities in poor condition; and the Adjutant General Priority Rating. Question. What process do you use to prioritize and rank the requests from State Guard Bureaus into a nationwide list of military construction projects? Answer. The Army National Guard continues to use the Infrastructure Require- ments Plan (IRP). This process starts with the submission by each of the 54 States/ 285

Territories/the District of Columbia of the top #1 and #2 major military construction (Milcon) projects. These are ranked against each other according to established criteria related to project characteristics. Those criteria are as follows: Support of force modernization; joint use project; resolves existing health and safety or environmental problem; equitable distribution of projects; replacement of facilities in poor condition; and the Adjutant General Priority Rating. This National Guard project list is provided to the Army as part of the budget process. Question. When, how, and why was this process established? Answer. Beginning in 1996, Congress was concerned about how the Army Na- tional Guard prioritized their Military Construction Projects. The National Guard took the opportunity and did a comprehensive review of its planning process. As a result, now has the Infrastructure Requirements Plan (IRP), a process which has served well for the past 14 years. Question. It is my understanding that Army National Guard facilities are an average of 41 years old, 24 percent are over 70 years old, and the military construction requirements for Army Guard facilities has been estimated to be around $1.5 billion per year over the next 20 years to bring these facilities up to current standards. Is the Army National Guard’s request for fiscal year 2011 sufficient to address the Army Guard’s infrastructure needs? Answer. The current Future Years Defense Program contains only a fraction of what is necessary in both military construction (Milcon) and Operations and Main- tenance (O&M) Restoration and Modernization to adequately refurbish these facilities to a standard that enables a 21st Century Army National Guard Operational Reserve. The Army Guard’s request for Milcon is $873 million in fiscal year 2011 decreasing to $354 million in fiscal year 2015. The Army National Guard’s plant replacement value for the over 26,000 plus facilities is estimated to be more than $40 billion where 40 percent of ARNG Facilities are greater than 50 years old. It would take in excess of $16 billion over the next 10 years to recapitalize just the aging facilities ($1.6 billion a year). A significant portion of the National Guard facilities inventory is readiness centers. Over 3,000 readiness centers, approximately 1,247 of them are greater than 50 years old and most will require recapitalization in the next decade. We will have a better understanding of our infrastructure investments needs once the National Readiness center study directed by the Senate Report 111–201 is completed. We plan to address our critical readiness center requirements with the required funding and more importantly stop the increasing decline of our facilities inventory condition and deficits to continue to meet mission readiness. Question. What is the average age of California Army National Guard facilities? Answer. The average age of California Army National Guard facilities is 48 years old. Question. Under the current FYDP and general facility replacement schedules, what will the nationwide average age of a National Guard facility be in 2020, 2030, and 2040? Answer. The following criteria and assumptions are applied to calculate ARNG responses: —Start point real property inventory used was September 2010 and included active, semi-active, excess, caretaker, closed, and surplus status facilities. —Inventory excluded TBA and disposed status facilities. —Inventory included both DOD and State owned and leased facilities. —Inventory included all facilities: buildings, structures and linear structures. —Inventory included ARNG facilities on over 100 enclaves for which the ARNG is responsible. —Assumed that the one for one disposal to offset additional new construction remains in effect through 2040. Therefore no additional disposal beyond the amount constructed is considered. —Based on sizes of new construction versus facilities being disposed assumed each newly constructed building is offset by two older buildings. —ARNG will construct about 50 new facilities each year. —Facilities older than 50 years are not leaving the inventory because they are eligible for historic status. —Facilities being constructed each year are replacing facilities that are 50 years old. —These assumptions result in the overriding assumptions that under the current FYDP and general facility replacement schedules, each year 50 new facilities will replace 100 buildings that are 50 years old. This will reduce the total number of facilities by 50/year and reduce the total number of years by 5,000 each 286

year. Based on these realistic assumptions given the number of facilities (over 95,000) they make no measurable difference. Question. Under the current FYDP and general facility replacement schedules, what will the average age of a California National Guard facility be in 2020, 2030, and 2040? Answer. Under the current FYDP and general facility replacement schedules, the average age of California Army National Guard facilities will be 58 years in 2020, 68 years in 2030, and 78 years in 2040.

BLACKHAWK HELICOPTERS Question. California has a significant amount of high altitude terrain and heavy historical utilization of UH–60 and HH–60 Blackhawk helicopters in emergency response missions. What factors will the National Guard Bureau take into account when making the decision on where to assign additional modernized UH–60 L and M Blackhawk helicopters in the Army National Guard and HH–60 Blackhawks in the Air National Guard? Answer. Many factors are considered when stationing modernized helicopters in both the Army National Guard and Air National Guard. A major factor is the Army Force Generation Model that assigns units to deploy overseas for Federal missions. Other factors include availability of aircraft in a state and region by type and state of modernization, the terrain of the region and suitability of other ground and air assets to support operations. Question. Specifically, will you consider unique geographical constraints and historical utilization rates in emergency response missions when determining assignments? If not, why not? Answer. The National Guard does consider geography and the threat of natural disasters when stationing units. Historical utilization rates are considered and are balanced against the increased capacity of modernized aircraft. Question. What other factors will the National Guard Bureau take into account and how do you determine and prioritize/rank those factors? Answer. National Guard Bureau first considers the availability of a unit for the Warfight when fielding modernized aircraft in order to reduce sustainment and logistical support requirements when units that are stationed across multiple states merge together on a deployment. The next scheduled deployment is considered to ensure a unit has enough time to train on modernized aircraft between fielding of the equipment and deployment. Other factors such as terrain, availability of other aircraft and historical flood, fire, hurricane and other natural disasters is also considered.

QUESTIONS SUBMITTED BY SENATOR SAM BROWNBACK Question. Tight budgets are going to force us to make the best possible use of government and military facilities. Kansas recently announced it is closing several armories due to budget constraints, and several State budgets are experiencing shortfalls. The Federal budget for facilities also is limited and likely to shrink in the future. Because of these constraints, it might be useful to consider shared-use facilities for Guardsmen, and other public safety-related state and Federal personnel. Have you considered a shared-use facilities concept? Are you aware of any short- term steps that might be taken to create shared-use facilities or any legal or policy barriers that would need to be addressed to make the concept work? Answer. The National Guard has considered shared-use facilities and has constructed many installations in conjunction with State or Federal agencies, including other components of the Armed Forces. We are taking short-term steps to identify Federal shared use facilities through Joint Service Reserve Component Review Boards. State shared used facilities are presenting more of a problem, as many States lack the budget for major construction at this time. In addition to State-share requirements, incompatibility issues with Anti-Terrorism/Force Protection criteria and other Federal regulations make sharing facilities with the States difficult. We feel that the report language to accompany the fiscal year 2011 National Defense Authorization Act (NDAA) directed Readiness Center Study will illustrate additional opportunities for shared use facilities. Question. Up to now, the various resiliency programs have existed on seed money provided through various accounts in Congress. I am concerned that these programs may not survive as budgets get tighter. What steps are you taking to capture the best practices from the various resiliency programs and make them available to Guardsmen and women around the 287 country, and will you be able to institutionalize these resiliency programs as other priorities compete for space in the budget? Answer. The National Guard Bureau continues to work to develop more efficient and effective resiliency programs. One major success of the National Guard has been the The Yellow Ribbon Reintegration Program (YRRP). This program has worked extremely well for the Army and Air National Guard. Through May 2009, the National Guard has already conducted 619 events involving 47,182 service members and 58,350 family members. These attendees have had access to information, services, referrals, and proactive outreach to Services members, families, and employers throughout pre-deployment, deployment, and post-deployment. The YRRP is made available to all members of the Army and Air National Guard when they deploy. Additionally, the National Guard makes every attempt to ensure that all Service branches within our States, Territories and the District are included, whenever possible, in our Yellow Ribbon Reintegration Program process throughout all phases of the deployment cycle.

QUESTIONS SUBMITTED TO LIEUTENANT GENERAL HARRY M. WYATT III

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

AIR NATIONAL GUARD FIGHTER SHORTFALL Question. General Wyatt, in the statement submitted for the record, you observed that ‘‘80 percent of our F–16s will begin reaching the end of their service life in 7 years.’’ Retiring these aircraft will significantly reduce the fighter aircraft that the Air National Guard has dedicated to the Combat Aviation and Air Sovereignty Alert missions. How serious a problem is the fighter shortfall facing the Air National Guard and what steps are being taken to reduce the associated risk? Answer. The ANG faces a substantial fighter force shortfall in the near term which becomes critical by fiscal year 2016–17. By fiscal year 2017 up to six ANG F–16 units may reach the end of their service life. To address this risk, the Air Force is funding and executing full-scale fatigue tests on aging F–16 aircraft to determine the feasibility of a service life extension program (SLEP). Question. General Wyatt, what force management options could be taken if the F–16 fleet sees significant aircraft retirements before replacement aircraft are available? Answer. If recapitalization does not occur in a timely manner and the Air Na- tional Guard (ANG) experiences significant aircraft retirements without replacement, the only option available for units without aircraft is to retrain, relocate, or retire their experienced ANG personnel. A preferable alternative to ‘‘retrain, relocate, or retire’’ is concurrent and balanced recapitalization. Addressing the needs of the ANG during recapitalization efforts ensures the ANG and its highly efficient, knowledgeable, and cost efficient forces remain available for Combatant Commander tasking at Home and Abroad.

C–130 FORCE STRUCTURE CHANGES Question. General Wyatt, in fiscal year 2011 the Air National Guard will lose 18 aircraft through a combination of retiring 6 C–130Es and transferring 12 C–130Hs to the active component. To minimize the adverse impact, the plan is to remove one or two aircraft from multiple sites and reduce the size of the squadrons. The exception is a unit in Puerto Rico that will lose its last C–130Es next year. What is driving this change in your force structure and what are the consequences for the Air National Guard? Answer. Continuing budget pressures, the rising cost of maintaining and operating older weapons systems and the need to recapitalize aging tactical airlift assets are behind the programmatic actions in the fiscal year 2011 budget request. The reduction in airlift assets will result in fewer assets available to carry out both the Federal and State missions in response to any event or conflict. We are working with the Air Force and the Adjutants General to minimize the impact of the force structure changes. Question. The Air Guard unit at the Luis Munoz International Airport in Puerto Rico loses its last 6 aircraft (C–130Es) in fiscal year 2011. The Air Force has not yet decided what new mission the unit will receive. General Wyatt, we understand that the Air Force was concerned about having too much of the C–130 force in the Guard and Reserves. Can you shed some light on the problem being solved with the proposed shift of aircraft to the active component? 288

Answer. Recent air force studies have suggested that there is an issue with the ratio of C–130’s in the Guard and Reserves to those based in active duty units. The study suggests that the ability to access reserve component aircraft is limited, and could be fixed by basing more C–130’s in the Active Duty. It is my belief that the ANG C–130 community has proven over the last decade through volunteerism and mobilization that access to ANG iron is not an issue. Although our fleet size has been reduced by 20 percent due to BRAC and Air Force programmatic changes, we continue to increase our level of effort to the total airlift requirements of our nation. This level of ANG C–130 fleet effort cannot be measured strictly by the number of tails currently deployed to Afghanistan and Iraq as studies have suggested, but should also include the total level of effort that our ANG C–130 fleet shoulders on a daily basis. I would remind everyone that the first C–130 aircraft to respond to the gulf area after Hurricane Katrina was an ANG C–130. This is the norm, not the exception. Question. General Wyatt, the Puerto Rico ANG C–130 unit is scheduled to lose all of its aircraft in fiscal year 2011. Have you and the Air Force identified a new mission for this unit? Answer. We continue to work with the Air Force basing process to identify the future mission for our outstanding unit in Puerto Rico. We have made a strong case that our ANG unit in Puerto Rico possesses many unique abilities, including language and cultural skills that should be leveraged by the Air Force. We also conclude that the location of Puerto Rico is unique and valuable as our only permanent airlift unit location in the Caribbean.

AIR NATIONAL GUARD—RECRUITING AND RETENTION Question. General Wyatt, in the last 4 years the Air Guard has undergone significant force structure adjustments. Most of these adjustments have been completed but there are still a few bases without long term missions. How has the restructuring affected recruiting and retention across the Guard and in particular at the units that still lack a future mission? Answer. Air National Guard recruiting and retention remains strong. The challenge as we move forward is to strike a delicate balance of remaining close to end strength while strengthening ‘‘effective’’ recruiting. We have been very successful with quickly matching missions for a majority of our units in transition and have been diligently working with the Air Force on the few units we have had trouble matching with follow-on missions. Question. General Wyatt, are you concerned that a decision on the new missions will not be reached in time to include funding in the fiscal year 2012 budget? What is holding up the decision? Answer. Our BRAC experiences have enabled us to rapidly match the right mission to the right unit. We will continue working with HAF to ensure the timely decisions and appropriate funding requests. The Executive Steering Group (ESG)—Strategic Basing Process is still a relatively new process and continues to be refined to increase efficiency. The ANG is fully integrated in the process and continues to work with HAF. While often time intensive, this deliberate process ensures the necessary vetting and review of basing actions.

QUESTION SUBMITTED BY SENATOR SAM BROWNBACK Question. For the last few years, the Air National Guard has been working on a program to demonstrate the capabilities of the AT–6 light attack aircraft. During this time, the concept of a light attack aircraft has gained traction in various parts of the Department of Defense. In fact, the Air Force announced that it intends to purchase several light attack, armed reconnaissance (LAAR) aircraft beginning in fiscal year 2012. Has the active duty Air Force—or anyone else from across DOD, contacted the Air National Guard about lessons learned from the demonstration program? Alter- natively, have you reached out to interested parties at DOD—to include the active duty component of the Air Force, the Navy, SOCOM and JFCOM—about the importance of the AT–6 demonstration program and its relevance to the development of a LAAR-type aircraft? Answer. The Air National Guard has been working closely with the Air Force on light attack efforts so that all involved are informed on the progress, results, and lessons learned from the various efforts. The AT–6 demonstration is a congressionally mandated demonstration that will provide platform-agnostic lessons learned that can be applied to any light attack effort or future acquisition programs. The Air Force has received inquiries about AT–6 Demo effort from the JFCOM/CC, 289

EUCOM staff, and most recently, the Director of the Iraq Training and Advisory Mission. Air Guardsmen working the AT–6 demonstration at the ANG Test Center in Tucson and at the National Guard Bureau have actively kept SAF and HAF, JFCOM, and the OSD special capabilities office aware of program status and future plans. The first formal phase of the AT–6 demonstration flights in an operationally representative environment just started in late March and will conclude on April 22. We invited Navy personnel working the IMMINENT FURY program to observe the testing occurring at Nellis AFB April 12–22, and Air Force personnel will also be involved with the Nellis effort. We will actively share the results of that first phase, and the second phase of flights planned for August and September, with all organizations in DOD involved with Light Attack. We have also initiated contact with the offices at AFMC that will be responsible for any future light attack aircraft procurements to ensure they receive and understand the results of the AT–6 demonstration so they may be incorporated into any future full and open competitions.

QUESTIONS SUBMITTED TO MAJOR GENERAL RAYMOND M. CARPENTER

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

UH–60 BLACK HAWK UPGRADES Question. General Carpenter, one of the Army Guard’s top priorities is to modernize the oldest UH–60 Black Hawks to the latest configuration. The budget contains funds to upgrade 35 of these helicopters. How many of those conversions would directly benefit the National Guard? Answer. Current information indicates that 30 of the 35 A–A–L conversions in the budget will be coming to the Army National Guard. The Army UH–60 ‘‘A to A to L’’ upgrade program is a critical element for the timely modernization of the ARNG UH/HH–60 fleet, which comprises the largest and most heavily used part of the ARNG rotary-wing inventory. The ARNG is quickly approaching its full authorization of 849 UH/HH–60 aircraft. When that occurs, almost 500 of those will be the older and outdated ‘‘A’’ models that average over 30 years of age. At the presently programmed rate of future buys of ‘‘M’’ models and ‘‘L’’ model conversions, the Army Guard will not be able to divest of the final ‘‘A’’ models until well into the 2020’s. Future ‘‘A–A–L’’ conversions are currently planned a rate of 38 per year. Question. General Carpenter, the dependence on helicopters in Iraq and Afghani- stan has created a strain on our depots because of all the repairs needed on aircraft returning from overseas. Do you know if our depots have adequate capacity to accelerate the Black Hawk modernization program? Answer. These efforts are performed at the Corpus Christi Army Depot (CCAD). In regards to CCAD’s capacity, the Depot could ‘‘expand/increase’’ its capacity beyond the current production for the UH–60 A–A–L RECAP of 38 aircraft per year; however, there is no existing requirement to do so. Any increase above the current requirement would entail a ramp up to properly set the conditions for success. Additional resources, to include staffing, tools, spare parts, facilities, and funding; could be needed depending on the number of additional aircraft to be addressed per year.

RESERVES STATEMENT OF LIEUTENANT GENERAL JACK C. STULTZ, CHIEF, ARMY RESERVE Chairman INOUYE. And now may I call upon the second panel, Lieutenant General Jack Stultz, Chief of the Army Reserve; Vice Admiral Dirk Debbink, Chief, Navy Reserve; Lieutenant General John F. Kelly, Commander, Marine Forces Reserve and Marine Forces North; Lieutenant General Charles E. Stenner, Jr., Chief, Air Force Reserve. Gentlemen, thank you for joining us this morning. And may I assure you that your full statements will be made part of the record. And may I now call upon General Stultz, Chief of the Army Re- serve. General STULTZ. Mr. Chairman and Vice Chairman Cochran, it is an honor to be here and, first and foremost, to say thank you for all of the support that you’ve given the well over 207,000 soldiers that currently populate the Army Reserve. I know we’re going to be pressed for time, and I don’t want to take a long and drawn-out opening statement. I do want to recognize two soldiers that I did bring with me today, because I think they epitomize what Ray Carpenter talked about, that’s referred to as a national treasure, and that is what we call ‘‘warrior citizens.’’ You used to be called ‘‘citizen soldiers,’’ and when I came into this job as the Chief of the Reserve, we changed the term to ‘‘warrior citizen.’’ And I took a little flak about that, because people said, ‘‘That’s a little harsh.’’ And I said, ‘‘I don’t think so, because our soldiers, today, in uniform are warriors. They are an operational force. They’re making, in a lot of cases, the ultimate sacrifice.’’ We have lost a number of our Reserve component soldiers, sailors, airmen, and marines in combat. And so, these two soldiers that I want to introduce epitomize that national treasure that we’ve got. The first one is Second Lieu- tenant Rachel Milton. Second Lieutenant Milton joined the Army Reserve after 9/11, to serve her country, and she became a private in the Army Reserve. She deployed to Iraq as a specialist, E–4 medic, where she was working inside Abu Ghraib prison, treating prisoners, both inside the prison and in the grounds. But also, during her other time, she was out doing convoy security, where she was a .50 cal gunner in a Humvee, providing security to convoys moving in and around that area of Iraq. And, additionally, was part of a four-person team who flew back and forth into the Green Zone during the Saddam Hussein trial to provide medical support to him and others that were participating in that trial. Came back home from her deployment to Iraq, went back to school, got her bachelor’s degree in nursing, became a nurse at a hospital in New York City; in 2 years, has already been promoted to charge nurse and is now getting ready to enter her master’s program. That’s the (291) 292 return on investment we get; where we take a young person who is a patriot, put them into the Army Reserve, or the other Reserve components, and let them develop on their own, and let them become leaders, and then let them go back to their communities and give back. So, now, here in the Army Reserve, I’ve got an officer, I’ve got a trained nurse, I’ve got a combat veteran standing before you. A true hero. The other individual is Sergeant David Foltz. Sergeant Foltz is an engineer. Sergeant Foltz deployed in 2003–2004, in support of the war, and then went back again in 2006–2007. Part of an engineer unit that was out in the Anbar Province during a very, very contested time, which I’m sure General Kelley is very familiar with, doing route clearance. His battalion clearing a number of improvised explosive devices (IEDs) that saved thousands of soldiers and marines’ lives as they cleared them, but, in that battalion, lost six of their own soldiers, and 25 percent of their unit received the Purple Heart throughout that battalion. Came back home, works for me in the Army Reserve now as a civilian, giving back not only in terms of his technical skills, but giving back in terms of his leadership as a noncommissioned officer; that which distinguishes our Army from any other army in the world, the backbone of our Army. This is why I’m here today, sir, to say we need your continued support and the continued support of Congress, for these great young men and women who are in our ranks who are truly national treasures. I’ll look forward to your questions, sir. Thank you. PREPARED STATEMENT Chairman INOUYE. We thank you for your service to our Nation, and we salute you. General, finish with your—— General STULTZ. Yes, sir. As I said, I look forward to your questions. [The statement follows:]

PREPARED STATEMENT OF LIEUTENANT GENERAL JACK STULTZ Against the backdrop of the second longest war in our nation’s history and the longest ever fought by an all-volunteer force, the Army Reserve continues to be a positive return on investment for America. The fiscal year 2009 $8.2 billion Army Reserve appropriation represented only 4 percent of the total Army budget, yet we supply the Army seven to eight brigade-size elements. Since September 11, 2001, the Army Reserve mobilized 179,782 Soldiers, and now has 29,000 deployed in support of Army missions. We supply the Army with 87 percent of its Civil Affairs capability, 65 percent of its Psychological Operations, and 59 percent of its Medical support—to highlight a few of our top contributing specialized functions. Compared to the cost of expanding the full-time force, the small investment in the Army Reserve provides security at home and fights terrorism abroad. We respond to domestic disasters and participate in security cooperation operations while protecting national interests around the globe. In support of contingency operations, we foster stability in underdeveloped nations where conditions are ripe for terrorists to gain a foothold. The events of September 11, 2001 forever changed the way in which the Army Reserve provides combat support and combat service support to the Army and to the Joint Forces. Operational demands for Army Reserve support have been heavy and enduring. Operations in Afghanistan soon led to urgent calls for logistical, engineer, military police, medical, and civil affairs capability. The Army Reserve has the largest share of these capabilities and was soon meeting Combatant Commanders’ urgent requests. Theater requests have grown larger since operations began in Iraq in 2003. Every year through 2006, Combatant Commanders anticipated needing 293 fewer troops, but mission demands forced them to keep requesting more troops and support capabilities. In 2007, the ‘‘surge’’ in Iraq reversed that country’s descent into civil war, but sustaining that renewed commitment into 2008 represented yet further strain on the Army Reserve, its units and Soldiers, and their Families. As of October 2009, the beginning of the Iraq drawdown hints there may be some operational relief ahead, but new requests from Afghanistan for forces has triggered another presidential strategic re-assessment. The reality is, current operations are consuming Army Reserve readiness as fast as we can build it, but Congress’ support for the Army Reserve in recent years has gone far toward both meeting current demands and reshaping the Army Reserve for future national security requirements. As sustained operational demands on the Army Reserve became heavier after 9/ 11, it became ever apparent we could no longer function as a part-time strategic reserve. Based on the operational requirements outlined for the Army Reserve in the 2010 Quadrennial Defense Review, and while fighting two wars, we completed our transition from a strategic reserve to an operational force last year—to the extent we can—given today’s resourcing and mission demands. An operational Army Re- serve is a good return on investment for America because now we are in a stronger position to provide the Army with predictable, trained, equipped, and ready forces to meet global and contingency requirements. What remains is an ongoing effort to sustain an operational posture, with a fully functioning Army Force Generation model—that receives full funding. Thanks to Congress’ leadership, we have made great progress in a number of initiatives required to complete Army Reserve transformation. We have re-organized operational commands to better support theater requirements, opened new training centers, and restructured training commands to support the total force. Through Base Realignment and Closure, we have closed scattered facilities in favor of more efficient, multi-service reserve centers. Through the Army Reserve Enterprise process, we are restructuring our strategic and operational efforts to maximize productivity, efficiency, and responsiveness in four Enterprise areas: Human Capital, Ma- teriel, Readiness, and Services and Infrastructure. We have identified ‘‘Five Imperatives’’ to facilitate Army Reserve continued transformation to a stronger and more capable operational force. They are Shaping the Force, Operationalizing the Army Reserve, Building the Army Reserve Enterprise, Executing BRAC, and Sustaining the Force. Shaping the Force As we look ahead, we know that building the right force is crucial for success. In 2010, we will leverage human capital management strategies to better shape the force into a more affordable and effective Army Reserve capable of supporting national security objectives and our combatant commanders’ war-fighting needs. We are developing a more precise human capital strategy to meet our nation’s future military needs by ensuring the right people, with the right skills, in the right units, are in place at the right time. In today’s competitive recruitment environment, incentives matter because they allow the Army Reserve to sustain and shape the force. We achieved our fiscal year 2009 end strength due to the hard work and dedication of our recruiters and our Soldiers. We also attribute this success to the recruiting and retention initiatives that support the Army Reserve’s manning strategy. These include the Army Reserve Recruiter Assistant Program that promotes strength from within by recognizing and rewarding those Soldiers, Family members, and Department of the Army Civilians working for the Army Reserve who bring talent to the team. The second is enlistment bonuses, which help us recruit the critically short/high demand Military Occu- pational Specialties. In fiscal year 2009, our focused incentives increased Army Re- serve End Strength. As we met the objective, it became evident that not all of our new Soldiers possessed the skill sets needed to support the Army Reserve structure while also fulfilling our wartime requirements. Successful recruiting added an abundance of Soldiers in the lowest three pay grades, but recruiting new Soldiers as privates and second lieutenants cannot fill the thousands of mid-grade noncommissioned and commissioned officer vacancies that currently exist. Despite excellent retention results, these shortages continue. Our recruitment efforts will focus on more prior-service recruits who are slightly older and bring more experience than most first-term Soldiers. These experienced Soldiers can fill shortages among mid-level commissioned and noncommissioned officers. Targeted incentives have been crucial to rebuilding our end strength and addressing critical shortages in some grades and job specialties. Continuing these incentives allows the Army Reserve to shape the force to better meet the requirements of our national security strategy and to give Soldiers, Families, and Employers stability and predictability. 294

Ensuring a Continuum of Service (COS) is a human capital objective that seeks to inspire Soldiers to a lifetime of service. Active (full-time) and reserve (part-time) military service are two elements of valuable service to the nation. Continuum of Service provides Active and Reserve Components some of the means necessary to offer Soldiers career options while maintaining capability for the operational force. COS also recognizes the tremendous cost of accessing and training each service member and seeks to avoid unnecessary replication of those costs. To reach our objective, it is our intention to work with Army to propose recommended changes to current statutes and policies that will ease restrictions on statutes limiting Reserve Component Soldiers from serving on active duty. Operationalizing the Army Reserve Our status as an operational force means that the Army Reserve is no longer a force in waiting—we are an operational force in being. We can continue providing that positive return on investment to the nation when the Army Reserve is given the proper resources to succeed. The Army Reserve plays a vital operational role in overseas contingency operations and will for the foreseeable future. 179,782 Army Reserve Soldiers have mobilized since 9/11 in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF); 45,000 have mobilized more than once. In 2009, the Army Re- serve mobilized 34,472 Soldiers to support Combatant Commanders’ requests for forces. We execute a readiness strategy to deploy highly ready units and Soldiers to support OIF and OEF requirements. This readiness strategy synchronizes those strategic planning and resourcing actions necessary to generate sufficient manning, training, and equipping levels to meet combatant commander mission requirements. The Army Force Generation process allows for a structured progression of increased unit readiness over time, and provides the Army recurring access to Army Reserve trained, ready, and cohesive units, which translates to predictability for Soldiers, their Families, and Employers. In effect, ARFORGEN drives the battle rhythm of the Army Reserve. ARFORGEN works for the Army Reserve. It has enduring qualities that have been apparent in providing support to emergencies such as Hurricane Katrina and the Haiti earthquake relief efforts, for training Soldiers in Afghanistan, to supporting the African Contingency Operations Training and Assistance Program with training and equipment for selected militaries engaged in humanitarian or peace operations. The Army Reserve seeks continued support from Congress to be an effective responder to missions such as these. Within the transformation process, we realigned our force structure to meet the Army’s global mission requirements in both the Operational and Generating Force categories. The Army Reserve is ready to take on additional missions as the Depart- ment of Defense and U.S. Army validate emerging requirements. Authorized growth in end strength will enable the Army Reserve to activate validated units to meet these emerging requirements and maintain the number of units we have in our ARFORGEN process. Plans reflect an increase of 1,000 to 206,000 spaces of Author- ized End Strength (ESA) to provide the Army Reserve capability to meet emerging mission requirements within our ability to operate the force. Full-time support personnel comprise a select group of people who organize, administer, instruct, recruit, and train our people; and who maintain supplies, equipment, and aircraft. They also perform other functions required on a daily basis to maintain readiness in support of operational missions. Without these critical Sol- diers and Civilians, the Army Reserve could not function as an operational force. Although resourced to the Department of the Army ‘‘High Risk’’ funding methodology (meets minimal acceptable risk in support of a strategic reserve force), it is imperative that future planning ensure full-time support is fully resourced as an operational reserve. Adequate resourcing is critical in meeting the readiness requirements of the Army Force Generation (ARFORGEN) model. The current full-time support model remains a strategic reserve legacy. Key legislative and policy modifications are required to change personnel support processes. Manpower models and programming processes require review and modifications to provide flexibility and rapid response adjusting resources amid changing priorities across the ARFORGEN process. Our Active Guard Reserve (AGR) and Military Technician (MT) programs provide the bulk of full-time support at the unit level. They provide the day-to-day operational support needed to ensure Army Reserve units are trained and ready to mobilize within the ARFORGEN process. The AGR and MT programs are vital to the successful transition to—and sustainment of—an operational reserve. The Army Re- serve requires added flexibility in its hiring practices to sustain its commitments to ARFORGEN. We must take action to create a new category of Non-Dual Status 295

Technician, which allows retention and direct hire of personnel from outside the Se- lected Reserve. This new capability will allow us to support non-mobilizing/deploying organizations while authorizing Dual Status Military Technicians to meet conditions of employment with a military assignment anywhere within the Selected Re- serve. We are working with Army to relax legacy fulltime support policies in order to provide flexibility in the reallocation of resources within AFORGEN cycle. As an operational force, the Army Reserve must have the most effective and sustainable equipment for Soldiers and units at the right place and at the right time. The Army Reserve supports the Army Equipping Strategy of Cyclical Readiness, which means all units are equipped based on their position in the ARFORGEN process and their mission—regardless of Component. The Equipment Readiness levels increase as units move through the ARFORGEN process from the RESET to the Available Phase. Those units that are within the RESET phase start with zero readiness expectation. As the units move to the Train/Ready phase, they will be resourced from 80 percent growing to 90 percent; and once the units enter the Avail- able Phase, they are resourced to ensure 90 percent plus equipment readiness. To maximize collective and individual training opportunities for our units in the ARFORGEN process on high demand/low density systems, the Army Reserve must address the challenge with small pools of current generation systems. Additionally, while the Army Reserve units in the Reset Phase should have minimal specific equipping expectations; the Army Reserve is identifying equipment requirements that a unit can properly maintain at a Reserve Unit Home Station while sustaining Soldiers and training readiness. We are thankful to Congress for helping us meet this goal with National Guard and Reserve Equipment Appropriation (NGREA) funding. These funds greatly add toward operationalizing the Army Reserve by supporting Army Modularity, Homeland Defense/Homeland Security, and the Army Force Generation cycle with a fully modern and interoperable force. With continued NGREA funding, we will be able to train our Soldiers on the latest combat equipment before they deploy into harm’s way. Enterprise Transformation Using an enterprise approach to managing our internal processes, we add value to the Army by applying a holistic approach to managing our resources and shape the force into what is beneficial for the Army Reserve and supports the needs of the Army. By ‘‘shape the force,’’ I mean taking a fresh approach to how we recruit and retain the best and brightest, and positioning them in the right place, in the right job, and at the right time. The Army Reserve Enterprise consists of four core management areas: Human Capital, Readiness, Materiel, and Services and Infrastructure. To optimize the enterprise we must: Attract and retain the very best Warrior Citizens to serve our nation (Human Capital), Prepare, train, and equip Soldiers (Readiness); provide our Soldiers with the latest mission ready modular force equipment, (Materiel); provide for the well-being of our Soldiers, Families, Army Civilians, and employers while providing training and unit facilities and secure, redundant communications (Serv- ices and Infrastructure). Working together, these core management areas enable the Army Reserve enterprise to realize its ultimate goal: predictable, trained, and ready units—the essential components that define CAPABILITY. BRAC We have facility responsibilities at more than 1,100 Reserve Centers and the installations of Fort McCoy, Fort Buchanan, and Fort Hunter-Liggett installations. We also are responsible for significant training areas at Jolliet, Devens Reserve Forces Training Area, and Parks Reserve Forces Training Area. Moving toward completion of the current BRAC cycle of 2005, the Army Reserve military construction priority is to complete the remaining projects budgeted at $361 million for fiscal year 2010. Supporting the transformation of the Army Reserve from a Strategic Re- serve to an Operational Force, we will implement 21 construction projects at a cost of $381 million. Our construction effort supports the realignment of the field command organizations into Operational Supporting Commands. The resultant Sup- porting Commands invested $561 million in operating the facilities and some $244 million in repair of those facilities that allows mission accomplishment for the Oper- ational Commands. Sustaining the Force The Warrior-Citizens of the Army Reserve and their Families embody a lasting commitment to serve America. The Army Reserve recognizes the strain of this era of persistent conflict on Soldiers and Families. We know Family readiness is inex- tricably linked to mission readiness, recruitment, and retention. Operationalizing of the Army Reserve creates a requirement for an enduring level of support. As the 296

Army Reserve transforms, so must Family Programs. Our way ahead includes realignment actions to: support the Army Reserve Enterprise management approach, sustain services to Soldiers and Families in the expeditionary force, standardize existing programs and services across the Army Reserve, and build partnerships with Army Families and communities. Our end state is to optimize programs and services to connect Soldiers and Families to the right service at the right time. The cornerstone of our planning effort is to ensure the integration of Family Sup- port services with the ARFORGEN process. By doing so, we ensure that our War- rior-Citizens and their Families have solid programs that are ready for execution any time during the training and deployment cycle. Appropriate resourcing will allow us to assess structure requirements, staffing needs, and develop effective processes that ensure the consistent delivery of programs and services that meet the needs of ARFORGEN and especially for those of our geographically dispersed customers. The Army Reserve Family Programs Virtual Installation Program is an exciting new initiative that ensures the same services provided to active component Soldiers are available to all service members and their Families not living close to a military installation. Leveraging assets we have on hand is allowing us to test the program through a series of pilots located in selected communities. Funding for this priority will allow us to expand Virtual Installation within Army Strong Community Centers around the country and overseas. We must continue to increase the quantity and quality of support for Army Re- serve children and youth. We can increase opportunities for youth to develop leadership skills and strategies for coping with separation. Teen panels provide forums for our youth to propose solutions for concerns that affect their lives during mobilization and deployment. Additional online teen deployment classes support youth living in the ‘‘new normal’’ of repetitive deployments. With additional resources, we will work with our community partners to expand childcare for geographically dispersed Families and respite care for mobilized Families. This year we provided new opportunities for children of Army Reserve Families to attend camps. While the Department of Defense (DOD) ‘‘Purple Camps’’ were a great initiative, they distributed opportunities among all military communities in DOD. This resulted in fewer opportunities for Army Reserve children than needed. Additionally, Army Reserve children are usually unable to travel, and require activities located in areas near their homes. By operating our own camps, we increased these opportunities to Army Reserve Families in their communities and tailored them to our communities. The goal of the program is to prepare Army Reserve Sol- diers and their Family members for mobilization, sustain Families during deployment, and reintegrate Soldiers with their Families, communities, and employers upon release from active duty. The Army Reserve Yellow Ribbon Reintegration Pro- gram (YRRP) provides information, services and support, referral, and proactive outreach to Army Reserve Soldiers and their Families through all phases of the deployment cycle. The program includes information on current benefits and resources available to help overcome the challenges encountered with Army Reserve mobilization and reintegration. The Army Reserve successfully launched its Yellow Ribbon Reintegration Pro- gram. We have coordinated with other military agencies, Federal/state/local government agencies, community organizations, and faith-based organizations to provide robust, preventive, proactive programs for Soldiers and their Families. Elements of the program include promoting preparedness through education, conducting effective Family outreach, leveraging available resources, and supporting the All-Volun- teer Force. During fiscal year 2009, the Army Reserve executed more than 250 Yel- low Ribbon events, serving some 12,000 redeploying Soldiers and 12,000 Family members. In interviews conducted by the Office of the Secretary of Defense, Soldiers and Family members reported positive experiences with the Army Reserve Yellow Ribbon Reintegration Program. The challenge to the Army Reserve remains to develop, improve, and sustain the mental, spiritual, and emotional health that fosters resilient Soldiers and Families. We are moving out aggressively to mitigate the effects of persistent conflict and build a strong, resilient force. Multi-symptom conditions including those signature wounds not visibly apparent (for example: Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), exist for Soldiers with military service in South- west Asia. We will work with Health Affairs and the other Services to continue to provide the care necessary for the wounds from the current conflicts. We appreciate the resources that Congress has provided to date to further programs such as the new GI Bill and TRICARE. The benefit of TRICARE Reserve Se- lect provides our Soldiers and Families peace of mind knowing that if a Soldier de- 297 cides to better him/herself career-wise with the skills gained while deployed, medical care will not be a worry if he or she decides to change careers. We are teaming with civilian industry to shape the Army Reserve into America’s premier reservoir of shared military-civilian skills and capabilities through our Em- ployer Partnerships programs. Through these mutually-beneficial alliances with businesses that share our valuable human capital, we can strengthen Soldier-employees, Families, employers, and communities. We seek to identify locations where our Soldiers can simultaneously add value to both the civilian workforce and the Army Reserve. This effort ties into our objective of achieving a continuum of service for Soldiers who want the option to transition from active and reserve components, and vice versa, to provide Soldiers flexibility with their career objectives, while allowing the Army Reserve to retain the best talent and critical skills capability. We are committed to minimizing turbulence to Soldiers and their Families while providing the most effective and efficient trained and ready units and forces to meet world-wide requirements. We must maintain current levels of predictability while making plans to increase it. The Army Force Generation process allows for a structured progression of increased unit readiness over time, and provides the Army recurring access to Army Reserve trained, ready, and cohesive units. While our commitment in Iraq may draw down, the requirement for forces to commit to other global missions will only increase. In 2010, we will work with Congress to ensure we obtain the necessary resources to sustain a viable Army Force Generation cycle that supports global commitments and new missions. Thank you. Chairman INOUYE. And now, General Debbink—Vice Admiral Debbink. STATEMENT OF VICE ADMIRAL DIRK J. DEBBINK, CHIEF, NAVY RE- SERVE Admiral DEBBINK. Chairman Inouye, Vice Chairman Cochran, thank you for the privilege of appearing before you today. My force master chief, Ronnie Wright, and myself want to begin by expressing our appreciation for your support for the approximate 65,851 sailors, and their families, of your Navy Reserve component. My written testimony does go into some length describing the programs that we utilize to ensure the Navy Reserve is a ready and capable force, responsive to both the needs of the Navy and Marine Corps team and joint forces for both strategic depth and operational capabilities, while at the same time providing the necessary support to our sailors and their families and, very importantly, showing our appreciation to the sailors’ employers. As I testify this morning, Navy Reserve sailors are operating in every corner of the world, shoulder-to-shoulder with Active Duty sailors and alongside soldiers, airmen, marines, and coastguards- men. On any given day, more than 30 percent of the Navy Reserve is providing support to Department of Defense operations. The Navy Reserve is ready now, anytime, anywhere, as our motto and, most importantly, our sailors proudly claim. While fully engaged in overseas contingency operations around the world, your Navy Reserve was also, most recently, involved in Operation Unified Response in Haiti. During the last 2 months, more than 950 Reserve sailors were proud and humbled to be able to provide over 21,000 man-days of support for the humanitarian assistance and disaster relief efforts in Haiti. Success in these operations, of course, is no accident, but, rather, it’s a result of your sailors’ can-do spirit combined with the support of chain of command and the proactive support of this Congress. Together, we seek to provide our sailors with the proper training, 298 equipment, and support, both abroad and back home, necessary to ensure their success. And Congress’ engagement with these efforts is greatly appreciated. A central focus of our manpower strategy continues to be the establishment of a true continuum-of-service culture that provides a life/work balance, which accommodates individuals’ circumstances while at the same time allowing us to sustain the necessary inventory of skilled and experienced professionals to meet the Navy’s total force requirements. The Chief of Naval Operations, the Chief of Naval Personnel, and I recently signed the Navy’s Total Force Vision for the 21st Cen- tury, which lays the foundation for the Navy to succeed in delivering the human component of our maritime joint warfighting capabilities. Recruiting, retaining, and properly employing the right sailors—Active, Reserve, and civilian—in the service of our country is both an operational and a fiscal imperative for the continued success of our Navy. Our 2011 budget request will enable the Navy Reserve to continue supporting current engagements and maximizes the strategic value of the Navy Reserve as a relevant force, now and in the future; a force valued for its readiness, its innovation, its agility, and its accessibility. We expect the future will call for even greater displays of all of these traits. It is a privilege to serve during this important and meaningful time in our Nation’s defense, especially as a Navy reservist. PREPARED STATEMENT I thank you for your continued support and your demonstrated commitment to our Navy Reserve and the sailors in that Navy Re- serve. I look forward to your questions. Thank you, Mr. Chairman. Chairman INOUYE. Thank you, Admiral. [The statement follows:]

PREPARED STATEMENT OF VICE ADMIRAL DIRK J. DEBBINK

INTRODUCTION Chairman Inouye, Vice Chairman Cochran, and distinguished members of the Senate Defense Appropriations Subcommittee, thank you for the opportunity to speak with you today about the capabilities, capacity, and readiness of the dedicated men and women who serve in our Navy’s Reserve Component (RC). I offer my heartfelt thanks for all of the support you have provided these great Sailors. I have now had the honor of serving as the Chief of Navy Reserve for 20 months. In that capacity, I am privileged to work for more than 66,500 Sailors in our Navy’s RC, an elite fighting force which just celebrated its 95th birthday. I am continuously amazed and humbled by the daily sacrifices our Reserve Sailors are making for our Nation and our Navy. Witnessing such great deeds helps me to focus on the services that I can provide to each of them: to ensure they are given real and meaningful work every day they are on duty; to ensure that they receive every practical material and organizational advantage to support them in their work; and to provide their families and employers with the proper support to honor and ease their sacrifices. Our Navy needs, and our Sailors deserve, the best Navy Reserve possible, and today’s Navy Reserve is as strong and as relevant as it has ever been. Our success is a direct result of the dedication and professionalism of our Sailors, which is a reflection of the tremendous support those Sailors receive from their families and civilian employers. Last year, the Navy Reserve adopted an official Force Motto: ‘‘Ready Now. Any- time, Anywhere.’’ This motto is our pledge to our shipmates, our Navy, and our Na- 299 tion and serves as the guiding principle of the Navy Reserve Strategic Plan. In that Plan, the mission of the Navy Reserve is defined: ‘‘to provide strategic depth and deliver operational capabilities to our Navy and Marine Corps team, and Joint forces, from peace to war.’’ As Chief of Navy Reserve, I can report without reserva- tion that our Navy Reserve Sailors accomplish this mission every day. The Navy Total Force is aligned with and supports the six core capabilities articulated in the Maritime Strategy and is managed by Navy leadership to enable the Chief of Naval Operation’s priorities: (1) build tomorrow’s Navy; (2) remain ready to fight today; and (3) develop and support our Sailors, Navy civilians, and their families. The Navy Reserve is integral to the Navy Total Force—we stand shoulder- to-shoulder with our active duty component executing full spectrum operations that represent every facet of our Navy’s Global Maritime Strategy. Within this Total Force framework, I would like to take this opportunity to update you on the programs that support the Chief of Naval Operations’ focus areas, while also highlighting some key contributions from Navy Reservists in 2009.

CARE FOR OUR WARRIOR FORCE This country owes a great debt to the men and women who have gone in harm’s way in support of contingency operations around the globe and it is our obligation to provide them not just with every opportunity to succeed while deployed, but also with the means to reintegrate once they return from overseas. Secretary of Defense Robert Gates has stated, ‘‘apart from the wars in Afghani- stan and Iraq, my highest priority as Secretary of Defense is improving the outpatient care and transition experience for troops that have been wounded in combat.’’ The Navy Reserve takes this commitment to heart and is setting a higher standard every day for the care and well-being of our Wounded Warriors. In 2009, we completed implementing programs recommended in the Naval Inspector Gen- eral’s Navy Reserve Wounded Warrior Care report, highlighted by the functional stand-up of the Reserve Policy and Integration organization (M–10) within the Bu- reau of Medicine and Surgery (BUMED). This organization provides BUMED with a Reserve perspective related to medical policies and issues impacting the Total Force. We continue to provide exceptional service to Sailors assigned to the Navy’s Medical Hold (MEDHOLD) units. These units provide necessary medical and non- medical case management to the Navy’s RC Wounded, Ill, and Injured (WII) population. For those Sailors and Coast Guardsmen who are seriously wounded, ill, or injured, the Navy Safe Harbor program is the Navy’s lead organization for coordinating non-medical care for the warrior and their family members. Through proactive leadership, MEDHOLD helps RC WII members return to service and their communities, and Safe Harbor provides individually tailored assistance designed to optimize the successful recovery, rehabilitation, and reintegration of our Shipmates. Superior care is not reserved for injured Sailors alone. Medical research indicates that health concerns, particularly those involving psychological health, are frequently identified during the months leading up to and following return from an operational deployment. Current Navy programs, such as Operational Stress Con- trol Training, the Psychological Health Outreach Program, and BUMED’s Wounded, Ill, and Injured Warrior Support, are designed to align with critical stages of the deployment cycle. An integral component of Force Health Protection calls for ensuring all service members are fit to deploy, and Navy has improved the screening procedures for mobilizing Sailors to ensure they are medically able to meet theater requirements. For example, the Medical Readiness Reporting System (MRRS) has improved tracking of each Sailor’s suitability for Area of Responsibility-specific expeditionary assignments. In addition, annual Physical Health Assessments (PHA), coupled with the new, standardized consolidated pre-deployment screening and local line support will streamline screening requirements while maintaining fidelity on issues which impact medical readiness. Early screening and associated fitness determinations help alleviate unnecessary stress on our Sailors and provides supported commands with a steady stream of well-prepared and able workforce. We are also actively engaged in implementing the new legislation that makes Reservists eligible for Tricare coverage up to 180 days before a mobilization event. We are thankful to Congress for their work in providing this benefit to our mobilizing service members. Sailors returning from overseas mobilizations are encouraged to attend a Return- ing Warrior Workshop (RWW), which is the Navy’s ‘‘signature event’’ within the De- partment of Defense (DOD) Yellow Ribbon Reintegration Program (YRRP). In the 8 years since 9/11, the overwhelming majority of Reserve Sailors mobilized to active duty have deployed as Individual Augmentees (IAs). Deployed apart from their parent unit and often assigned duties which differ greatly from their primary specialty, 300 these combat zone deployments can be uniquely stressful. The RWW is a dedicated weekend for Sailors to reconnect with spouses, significant others, and each other following an IA deployment. Staged at a high-quality location at no cost to the participants, the RWW employs trained facilitators to lead Warriors and their families/ guests through a series of presentations and tailored break-out group discussions that address post-combat stress and the challenges of transitioning back to civilian life. Additionally, my goal is to have a Navy Flag Officer in attendance at every RWW to make a visible statement of Department of the Navy support for this valuable program. A total of 43 RWWs have been held as of March 1, 2010, attended by 3,083 military personnel and 2,329 guests/family members. The fiscal year 2011 budget supports another 25 events. Pioneered by the Navy Reserve, these workshops are now available for all Navy IAs. RWWs are a true success story in honoring our Sailors and their families. It is one of my top priorities to ensure this program continues to have both the full support of Navy leadership and the widest possible participation by all returning Sailors. RWWs serve as a key component of the Navy Reserve Psychological Health Out- reach Program. Outreach teams assigned to each Navy Region Reserve Component Command facilitate the RWWs and engage in other critical aspects of the Deploy- ment Health Assessment (DHA) process. DHAs are regularly scheduled encounters used to screen service members prior to and after deployment and to facilitate appropriate psychological care. The DHA process supports the DOD health protection strategy to deploy healthy, fit, and medically-ready forces; to minimize illnesses and injuries during deployments; and to evaluate and treat physical, psychological, and deployment-related health concerns. The process is designed to identify stress injuries and other health concerns requiring further assessment or treatment as appropriate. The Navy Reserve now has dedicated mental health professionals and associated assets available to provide psychological health services for the Navy and Ma- rine Corps Reserve communities. Providing psychological health assessment services for deploying reservists will assist in identifying potential stress disorders and facilitate early intervention before these disorders accelerate to a more critical ‘‘injured or ill’’ stage, keeping Navy and Marine Corps Reservists psychologically healthy for continued retention in the Reserves and for future overseas and CONUS mobilizations. Also recently established as part of the YRRP, the Pre-Deployment Family Readiness Conference (PDFRC) utilizes Psychological Health outreach teams to provide education and information to ensure that Sailors and their families are ready for the rigors of deployment and the challenges of family separation. Additionally, Navy’s formalization and emphasis of the Operational Stress Control (OSC) Program is working to de-stigmatize psychological health issues, which can improve Sailors’ participation in valuable psychological health programs for those in need. The Navy Reserve team is a charter member of the OSC Governance Board. The Psychological Health Outreach teams provide the OSC Awareness brief during periodic visits to Navy Operational Support Centers (NOSCs) across the country. As of February 1, 2010, the psychological health outreach team members have made 196 visits to NOSCs, providing the Operational Stress Control Awareness brief to over 20,200 Reservists and staff personnel. Finally, and although not solely related to mobilized Sailors, the Navy Reserve has aligned closely with the Chief of Naval Personnel on programs that detect and help individuals who are at risk of suicide. Families, often the first people to notice a desperate change in a Sailor, are included in programs such as the PDFRC and the RWW. A Suicide Event Report (SER) is completed on all actual or attempted suicides, regardless of duty status, which has provided a more complete picture of the problems afflicting all Navy Sailors. In every instance where the chain of command knows of a Navy Reservist who has attempted suicide, either in a duty or non-duty status, the Reservist is referred to the Navy Reserve Psychological Health Coordinators for follow-up and referral to the appropriate mental healthcare services. The aforementioned OSC Awareness briefs provided by the Psychological Health Outreach teams also include Suicide Prevention briefs.

PROGRESS IN PROGRAMS FOR OUR PEOPLE The Navy Reserve Strategic Plan defines the vision for the Navy Reserve as follows: ‘‘Our vision for the Navy Reserve is to be a provider of choice for essential naval warfighting capabilities and expertise, strategically aligned with mission requirements and valued for our readiness, innovation, and agility to respond to any situation.’’ During the last 8 years, the Navy Reserve has demonstrated the ability to continue sustained and valuable contributions to the Total Force, in the full spectrum of missions, at home and abroad, and as both an operational and strategic 301 force. We continue to forge ahead with ideas and programs that will allow us to continuously contribute to the strategic aims of the Navy and the Joint Force. As defined in the Strategic Plan, one of the three Focus Areas for the Navy Re- serve is to enable the Continuum of Service (CoS). CoS reflects the reality of our Navy. As our Chief of Naval Operations, Admiral Gary Roughhead, states, ‘‘we are one force today. One Navy, with an Active Component and a Reserve Component.’’ CoS initiatives provide for seamless movement between the Active Component (AC), RC, and civilian service, while delivering operational flexibility and strategic depth at the best value for the Navy. Responding to the CoS philosophy, we recruit Sailors once and retain them for life through variable and flexible service options that provide a career continuum of meaningful and valued work. Not long ago, we spoke of creating active duty ‘‘on ramps’’ and ‘‘off ramps.’’ Today, a better analogy is that we’re all on the same career highway, and during our career we may wish to change lanes several times, moving from Active to Reserve and back. Our commitment to our Sailors is to make these lane changes easier and faster. CoS is forcing us to think differently and make big changes in the way we do business. Changing our culture might be the hardest part. Too often we think the only way to have a Navy career is by serving on active duty alone. Our Navy Reserve gives Navy Sailors many other possible ways to have a full Navy career. There were many important accomplishments associated with our CoS efforts in fiscal year 2009. Beginning last year, the Career Management System—Interactive Detailing (CMS/ID) allowed our AC career counselors to assist Sailors transitioning from active duty to consider Reserve units in the location where they planned to live. This is a good example of how an effective career development program can be a fantastic opportunity for Sailors to Stay Navy for Life. Additionally, Sailors in selected ratings and designators are informed about their eligibility for bonuses of up to $20,000 for affiliating with the Navy Reserve in the specialties we need most. Our Perform to Serve (PTS) program has given AC Sailors avenues for continued service in the AC Navy, primarily through transitions from overmanned rates into undermanned rates. Last fall, Navy expanded this program to allow AC Sailors the option to affiliate with the RC in their current rate to continue their Navy career. Integrating Reserve opportunities early into the Sailor’s transition process demonstrates the AC’s commitment to CoS initiatives. One of the most exciting developments supporting CoS is the new Career Transi- tion Office (CTO) within Navy Personnel Command. The goal of the CTO is to counsel Sailors before they leave active duty and through the transition process in order to help them to take full advantage of the opportunities in the Navy Reserve. By engaging our fully qualified, world-wide assignable personnel before they leave active duty, we can turn a personnel loss into a retention transaction without the need to involve a Navy recruiter. We started with officers transitioning from AC to RC, and immediately reaped success by nearly doubling Navy Veteran officer affiliation rates from 28 percent to 55 percent. We have recently expanded the program to include enlisted Sailors who elected the Selected Reserve (SELRES) option in PTS. In the future, the CTO will handle all officer and enlisted transitions from AC-to-RC and RC-to-AC, except mobilizations. Expanding our CoS efforts is one of my top priorities for fiscal year 2010. In the upcoming year, we will further our participation in the World Class Modeling initiative sponsored by the Chief of Naval Personnel to anticipate Navy warfighting needs, identify associated personnel capabilities, and recruit, develop, manage, and deploy those capabilities in an agile, cost-effective manner. Additionally, we will place Reserve information in the Navy Retention Monitoring System to provide enhanced reporting and analysis capabilities for retention metrics. With regard to educating a ready and accessible force, we thank Congress for its support of the post 9/11 GI Bill. The opportunity to transfer post-secondary education funds to a spouse or child is a significant benefit for our Sailors and their families. Since implementation on August 1, 2009, over 3,000 reserve members have been approved for transferability. We will continue to assess the impact of transferability on enlisted and officer retention. Another Focus Area for the Navy Reserve is to Deliver a Ready and Accessible Force. Reserve support for contingency operations in the Central Command Area of Responsibility (AOR) is one of the most critical elements in the success our forces have experienced throughout Operation Iraqi Freedom (OIF) and Operation Endur- ing Freedom (OEF). In fiscal year 2009, Navy Mobilization Processing Sites (NMPS) processed more than 7,400 Sailors for long-term active duty service. Of those Sail- ors, over 6,100 were mobilized to support Operation Iraqi Freedom and Operation Enduring Freedom in combat, combat support, and combat service support missions; 302 the remaining 1,300 were on Active Duty for Special Work orders providing valued support throughout the Fleet. In fiscal year 2010, Navy will continue to improve advance notification of personnel for upcoming mobilizations, with a goal of consistently providing at least 180 days prior notification for all recurrent and rotational mobilization assignments. Further, the Navy Reserve will continue to leverage the already robust Total Force Command IA Coordinator (CIAC) program at all NOSCs in order to optimize the frequency, quality, and depth of communications with mobilized reservists and their families throughout the deployment cycle. The CIAC program, complemented by the extraordinary efforts of our command and unit leadership teams, is significantly increasing quality of life for our deployed warriors and their families. Also, full-time, long-term support of Navy and Joint Flag Officer requirements by Reservists will help expand the expertise and knowledge of the Navy, and I thank you for the increased ability for Reserve participation in those assignments due to the legislation passed as part of last year’s National Defense Authorization Act (NDAA). The Navy Reserve executed the Navy Reserve Personnel (RPN) and Operations and Maintenance (OMNR) accounts, valued at $3.2 billion, at 99.9 percent in fiscal year 2009. The force executed nearly $150 million in discretionary Reserve Per- sonnel funding in support of missions world-wide, including $98 million in Active Duty for Training (ADT) funding—a 32 percent increase over fiscal year 2008—contributing 311,345 man-days of on-demand expertise to our Navy and Marine Corps team and Joint Forces. This operational support is a critical enabler to the Navy as Navy Reservists provide full-time excellence through part-time and full-time service. In fiscal year 2011, the budget requests $1.94 billion in baseline RPN, to include $190 million in discretionary RPN, and $1.37 billion in baseline OMNR appropriations. In addition to personnel support, Navy Reserve units and hardware contribute to Navy’s warfighting effort across multiple mediums, in missions ranging from combat operations or combat support operations, to logistics support around the globe, to training and readiness facilitation for soon-to-be-deploying units. The wide spectrum of missions that can be completed with Reserve units is in keeping with the third of our focus areas: Provide Valued Capabilities. Even when a Reserve unit itself is not mobilizing, our focus is centered on guaranteeing that Sailors are ready to provide necessary capabilities to the supported Combatant Commander. In fiscal year 2010, it is one of my top priorities to ensure the use of long-term budgeting processes to ensure sufficient Operational Support funding to meet Navy and Joint Force requirements. Demand for the services of our talented Sailors has never been greater, and we must solidify our access to the ADT dollars used to fund this on-demand expertise. Navy Reserve Sailors can be incredibly cost-effective, but there is a cost, and that cost must be incorporated in any long-term plan. This means planning and budgeting for the Navy Reserve to do the part-time work of the Navy. Some of the Navy’s work is ideally suited for the RC. For example, billets that require specialized skill sets on a periodic and predictable basis are the billets where the Navy Reserve can deliver great value on an ongoing basis while at the same time providing critical strategic depth in case of emergency. By working closely with the Navy to identify and quantify the work for the Navy Reserve, we can ensure the Fleet receives the support it requires and our Sailors will have real and meaningful work, delivering full-time excellence through part-time and full-time service. The Office of the Secretary of Defense (OSD) designated the Navy Reserve as the lead agency for managing the RC Foreign Language/Culture Pilot Program. This exciting new program encourages our Reserve Sailors to take classes at institutions of higher learning to expand their awareness of critical foreign language and cultures. Incentivizing our Sailors’ natural desire to learn will foster understanding across cultural lines which will shape our force for the better. Bonuses are awarded based on performance which can add up to $5,000 for strategic languages and cultural areas studied which are in high demand within DOD. The Navy continues to strive for ‘‘Top 50 Employer’’ recognition and the Navy Re- serve is in lock-step with those efforts. Top 50 organizations encourage innovation and focus on performance while taking care of their people through programs and policies that support a culture of trust, respect, communication, and collaboration. Maintaining a work environment that is conducive to quality work and leads to equal treatment of all personnel is paramount to the success of any organization. Sexual assault is a detractor from a healthy work environment, and it will not be tolerated in the Navy. The Navy Reserve participates in the Navy’s Sexual Assault Prevention and Response (SAPR) Cross Functional Team to ensure compliance with the Navy’s Total Force SAPR program instructions, policies, and procedures. Navy 303 leadership continually communicates a ‘‘Not in my Navy’’ stance towards Sexual As- sault through the ranks. The policies focused on enhancing the quality of life in the Navy have paid dividends for the Force. Fiscal year 2009 marked the second consecutive year Navy attained enlisted and officer recruiting goals in both Active and Reserve components. In the Reserve, enlisted recruiting was at 100.6 percent of goal; officer recruiting finished at 107.7 percent of goal. Not only did Navy find the quantity of recruits necessary to meet requirements, but the measured educational achievement of our recruits was at the highest level in years. SELRES retention numbers were equally strong, with attrition rates approximately 20 percent improved from fiscal year 2008 totals. There is still room for improvement in SELRES Officer strength, and numerous initiatives are underway to get SELRES Officer communities ‘‘healthy’’ by 2014, including targeted Officer affiliation and future retention bonuses, the increase of accession goals, refinements in the CTO process, and development of retention measurements and benchmarks. The value of recruiting incentives and special pays has been critical to every success the Force has enjoyed in this arena, and I thank you for providing us with the tools necessary to populate the Navy Reserve in the right manner while working towards the fiscal year 2011 budgeted end-strength of 65,500. Bonuses have helped shape the ‘‘Fit versus Fill’’ successes of recent years; however, for certain enlisted wartime skills sets and in the officer inventory in general, the Navy Reserve requires the help bonuses provide to continue to meet recruiting and retention goals.

WAY AHEAD In addition to the continuing attention to the programs and policies listed above, there are several other topics that have priority status this fiscal year to enhance our force-wide effectiveness, make it easier for each of us to serve, and to fully support our deploying members and their families. Foremost among my list of priorities is to achieve resolution on a path to fielding a Total Force Future Pay and Personnel System (FPPS). The Navy and Navy Re- serve currently have separate pay and personnel systems, designed and built in an era when Sailors rarely mobilized or transitioned between components. With the present system, it can take weeks to properly transition a Sailor from one pay and personnel system to another. This creates a barrier to realizing our CoS goals. FPPS would enable Sailors to transition quickly and seamlessly on and off active duty without the commensurate delays and confusion regarding pay and benefits. The Navy Total Force goal is to transition a Sailor from one component to another within 72 hours. Navy leadership understands the urgency of resolving this issue, which impacts every Sailor. I am confident that in fiscal year 2010, we will make considerable progress towards this goal. Another top priority this year is to ensure Navy has the funding allowing the RC to perform directed missions. In addition to working through the long-term budgeting process needed to pay for our Sailors, we are fully engaged in the development of Naval Aviation Plan 2030 to ensure that the valued capabilities delivered by the Navy Reserve are properly resourced. Navy Reserve aviation trains the Fleet, moves the Fleet, and when needed, surges to the fight. Twenty-eight squadrons, eight Fleet Replacement Squadron (FRS) Squadron Augment Units (SAUs), and 17 Chief of Naval Aviation and Training SAUs provided more than 70,000 flight hours in fiscal year 2009, including 80 percent of the Navy’s direct and indirect Fleet operational support. Our four adversary squadrons provided 76 percent of Navy capacity, and the Fleet Logistics Support Wing provided 100 percent of the shore-based Navy Unique Fleet Essential Airlift (NUFEA) with an average weekly cost avoidance of $655,000. These assets provide strategic surge capacity and maintain warfighting readiness at a lower cost, both in terms of payroll and airframe life, than AC squadrons. Navy Reserve’s lower Fa- tigue Life Expenditure (FLE) has provided Navy inventory managers increased options that have been a valuable part of Naval Aviation’s recapitalization plan generally, and of P–3Cs and F/A–18s in particular. Historically, Reserve aircraft have been procured via a combination of routine procurement processes, the use of National Guard and Reserve Equipment Appropria- tions (NGREA), Congressional buys, and the transfer of aircraft from the AC to the RC as new production aircraft enter the Total Force inventory. Current aviation procurement trends will challenge RC aviation capabilities as the Navy Reserve continues to recapitalize assets. Priorities include completing the C–40A (airlift) procurement and recapitalizing the electronic attack capability that is fully integrated into the Airborne Electronic Attack (AEA) deployment plan that has provided 12 years of combat deployments in support of COCOM requirements. 304

I am very appreciative of the Congress’ support for the purchase of three C–40A aircraft in the last two budgets. The C–40A provides twice the range, twice the cargo load, and twice the Ready for Tasking (RFT) days of the C–9B it replaces. The overall burdened hourly operating cost of the C–9B is $8,147/flight hour versus the C– 40A cost of $6,141/flight hour. As a result, a $42 million per year cost avoidance will be realized by completing C–40A procurement and retiring the 15 remaining C–9Bs. The fiscal year 2011 budget also supports the creation of a fourth Riverine Squad- ron for the Navy Expeditionary Combat Command (NECC). This additional unit was expressly addressed in the most recent Quadrennial Defense Review, and recognizes the unique skills and capabilities that the joint forces desire for current operations. NECC is manned equally by AC and RC personnel. We will continue to utilize NGREA as available to meet the needs of the Navy. NGREA has been a high impact capital infusion for the Navy Reserve since its inception in 1981, but has taken on added importance in recent years. While the Navy Reserve’s NGREA service allocation has decreased from 11.3 percent in 2004 to 5 percent in 2009, the appropriation has been instrumental in resourcing the capability of NECC and has bolstered the recapitalization of critical RC equipment in both Naval Aviation and the Surface Navy. In fiscal year 2009, the Navy Reserve executed NGREA funding to equip the Maritime Expeditionary Support Force, Ex- plosive Ordnance Disposal, Naval Construction Force, Naval Expeditionary Logistics Support Group, Naval Aviation and Surface Warfare units with: tactical and armored vehicles; Civil Engineering Support Equipment; communications equipment; Table of Allowance equipment; aviation modernization upgrades; and Rigid Hull In- flatable Boats. I am thankful for the $55 million NGREA allocated to the Navy Re- serve for fiscal year 2010. Secretary of the Navy Ray Mabus has committed the Navy and Marine Corps to meet bold, ambitious goals to advance Navy’s energy strategy. The Navy Reserve, in cooperation with the Naval Installations Command, is committed to providing the Secretary an innovative and agile RC that can and will be a significant force multiplier in the pursuit of these goals. Navy Reserve Military Construction and Facilities Sustainment, Restoration and Modernization (FSRM) projects will be stringently evaluated for efficient use of energy and water, use of new and emerging energy technologies, employment of innovative strategies and best practices, use of renewable energy sources, and energy- efficient mobility. Large-scale, comprehensive organizational efforts will be made in the use of energy efficiency and management tools. All Navy Reserve Military Con- struction and FSRM projects will incorporate conservation measures and environmental stewardship practices into their design and execution. The focus will be to reduce the cost and environmental impact of Navy Reserve construction projects by advancing energy efficiency and water conservation, promoting the use of distributed and renewable energy, and improving utility management decisions at all Re- serve facilities. Additionally, these energy goals can be helpful in facilitating transformation of the force; for example, completion of C–40A fleet logistics squadron recapitalization will offer a 13.2 percent fuel consumption reduction over the aging C–9B. Fuel savings in excess of 43,300 barrels per year will be realized when the C–9s are finally retired. The Navy Reserve is an agile, innovative force, and in no arena is that description more apt than in the realm of Information Dominance. Navy Reserve has engaged in a directed, efficient transition from legacy systems and has successfully piloted state of the art solutions that are currently in use and will be used by the Fleet of the future. Continued use of this responsive Force as the Navy’s test platform is critical in successfully deploying the latest technology in the most timely and cost effective manner possible. The threat posed to the government from aggressive actors in the cyber arena grows every day, and the Navy is engaged in actions to keep our country’s systems protected. Key to the Cyber Manpower Strategy is the development of an RC Surge capability. The vision is to transition current Cyber manpower into Reserve Cyber Units that would serve in this capacity. Also, an enhanced direct-commission program would allow for increased accession of Cyber specialists. Finally, the Navy is considering a Civilian Cyber Augment Force: an ‘‘on call’’ team of experts that can provide strategic relevance and depth to the Navy as the cyber environment changes and technical progress is made. Civilian experts and consultants can be rapidly hired under existing authorities to meet the emerging critical requirements of Fleet Cyber Command/Commander Tenth Fleet. We feel this effort can open unexplored areas of expertise in support of Navy’s Cyber vision and mission execution. 305

CONCLUSION Since 9/11, more than 62,000 mobilization requirements have been filled by SELRES personnel, along with an additional 4,500 deployments by FTS Sailors in support of the on-going conflicts in Iraq, Afghanistan, and the Horn of Africa. On any given day, more than 20,000 Navy Reservists, or about 31 percent of the Force, are on some type of orders providing support to global operational requirements of Fleet Commanders and COCOM global operational requirements. Our Navy Reserve Force—more than 66,500 Sailors—are forward deployed in support of Coalition forces, at their supported commands around the world, or in strategic reserve and ready to surge 24/7 if and when additional Navy Total Force requirements arise. I am proud to be a Navy Reservist, and I am humbled by the commitment of the men and women of our Navy Reserve. It is very rewarding and fulfilling to stand shoulder to shoulder with the Navy’s AC as we meet our Nation’s call to duty. I am honored to receive the support of Congress on key initiatives, such as providing TRICARE eligibility to ‘‘gray area’’ retirees. Although I readily admit my bias, there has never been a better time to be part of the Navy-Marine Corps team, and our Navy Reserve is clearly an integral part of the this hard-working, high-spirited and amazingly capable force. The Navy’s ability to be present in support of any operation, in war and peace, without permanent infrastructure in the area of operations, is a key advantage that will become even more important in the future. Our Navy remains the preeminent maritime power, providing our Nation with a global naval expeditionary force that is committed to global security, while defending our homeland as well as our vital interests globally. The Navy Reserve’s flexibility, responsiveness, and ability to serve across a wide spectrum of operations clearly enhances the Navy Total Force, acts as a true force multiplier, and provides unique skill sets towards fulfilling Navy’s requirements in an increasingly uncertain world. On behalf of the Sailors, civilians, and contract personnel of our Navy Reserve, we thank you for the continued support within Congress and your commitment to the Navy Reserve and our Navy’s Total Force. Chairman INOUYE. General Kelly. STATEMENT OF LIEUTENANT GENERAL JOHN F. KELLY, COMMANDER, MARINE FORCES RESERVE AND MARINE FORCES NORTH General KELLY. Mr. Chairman, Senator Cochran, like everyone at the table, I want to first start off by saying thank you so very much for all of the support you’ve provided the Reserve component for as long as I can remember, sir; and I’ve had a fair amount of experience in this city working these issues. There are in the neighborhood of 90,000—if you consider all classes of marine reservists, we’re about 90,000; almost 40,000 of them are being what we would consider to be drilling reservists, spread out across the country, like we all are, 183 different locations, 48 States, Puerto Rico. The strength of our Marine Corps Re- serve has always been, perhaps, first and foremost, the very, very large percentage of marines in the Reserve component have considerable Active Duty time—4, 6, 8, 10 years. Not all, but a considerable number. All of the requirements are the same. It’s a total force organization, to say the least. Marine reservists don’t consider themselves part-time marines or second-tier marines. It is one very large Marine Corps. Since 9/11, of course, one of the great strengths of the Marine Corps Reserve is that virtually all of us—all of them—have been involved in the fight at least once, and in many cases, multiple times. All of our battalions and squadrons have been called up or have had substantial portions activated and served at least once in Afghanistan or Iraq; 7,000 are mobilized today. I’m an Active Duty officer. I have used and abused reservists many times over my nearly 35 years in the Marine Corps, and I only saw one part of the Reserves. And I just wanted to share with 306 you, on this issue of operational versus Strategic Reserve. When I took this job, in October, my thinking was that the natural state of a reservist, or at least Marine Corps reservist, is weekend—a weekend a month and 2 weeks during the year. And that could not be—and you’ve heard that many times here this morning—could not be further from the truth. They see themselves as gunfighters because they are gunfighters. The vast majority of them have served as an operational Reserve since 9/11. And their appeal to me—and this comes from families, as well— is, as long as this fight is on, they want to be in it. And even when this fight is over, they want to continue in this operational Reserve mode, they don’t want to be put back on the shelf. And we ought not to lose their services as we go into the future.

PREPARED STATEMENT Recruiting is good. Retention is good. The marines are happy. The families are happy. I look forward to your questions. [The statement follows:]

PREPARED STATEMENT OF LIEUTENANT GENERAL JOHN F. KELLY Mr. Chairman, Senator Cochran and distinguished Members of the Subcommittee, it is my honor to report to you on the state of the Nation’s Marine Corps Reserve. I assumed command of Marine Forces Reserve (MFR) and Marine Forces North in October of last year; however, these past months have by no means been my first experience with the Reserve Component (RC). Over my many years as a Marine, but particularly over the course of three tours totaling nearly 3 years in Iraq, I have served with and fought alongside Marine Reservists and know first hand the mettle of these men and women. My appearance here today represents my first opportunity to share with you my assessment of these tremendous Marines, and to outline my priorities for the Force going forward. First and foremost Marine Forces Reserve continues to be an integral element of the Marine Corps’ ‘‘Total Force.’’ We share the culture of deployment and expeditionary mindset that has dominated Marine Corps culture, ethos and thinking since our beginning more than two centuries ago. All Marines stand eternally ready to answer the Nation’s 9–1–1 call and as our charter requires, is to ‘‘be most ready when the Nation is least ready.’’ The Reserve Component is trained, organized and equipped in the same way the active forces are, and consequently we are inter- changeable and forever leaning forward to deploy as the Nation requires. The Com- mandant of the Marine Corps recently stated that Marine Forces Reserve can be ‘‘whatever the Nation needs it to be,’’ an operational or a strategic reserve. Sus- tained combat operations and worldwide theater security cooperation and training commitments over the last 9 years more than suggest the essential need for the Re- serves to continue focusing at the operational vice strategic end of the continuum. Indeed, in the just-published United States Marine Corps Service Campaign Plan 2009–2015, Marine Forces Reserve is tasked no less than five times to train, organize and equip for participation as an ‘‘operational reserve’’ within the Corps’ Total Force. The Marines themselves, most of whom came to the Nation’s colors after 9/ 11 and have deployed deep into harms way, prefer this model and do not desire to assume lives as so called ‘‘weekend warriors.’’ This high level of flexibility, responsiveness and e´lan is only possible by the ever deepening bench of combat tested and uniquely qualified citizen ‘‘Soldiers of the Sea.’’ I am humbled daily by my interactions with these magnificent young Americans. Like their active duty brothers and sisters they sacrifice so much of their time, and so much of themselves, to protect and serve this Nation. The way they balance their family responsibilities, and civilian lives and occupations—and still stay Marine—amazes me. They do it with humility, without fanfare, and with a sense of pride and dedication that is consistent with the great sacrifices of Marines of every generation. They continue to affirm the Commandant’s conviction that today’s Marines are cut from the same cloth as those who fought conspicuously upon the battlefields of our Corps’ long history. 307

TODAY’S MARINE CORPS RESERVE The Commandant has said the Marine Corps Reserve will be whatever the Nation needs it to be. In the last decade, the nation has needed its Marine Reserves to be continuously engaged in combat operations in Iraq and Afghanistan and in regional security cooperation and crisis prevention activities. This tempo has built a momentum among our warfighters and a depth of experience throughout the ranks that is unprecedented in generations. The Marine Corps Service Campaign Plan calls for the employment of an operational reserve no less than 5 times. Understanding that we are fighting a transnational enemy and that partner nations will continue to seek our training and mentoring capabilities, I expect our Marine Reservists to be in great demand during the coming years in a sustained manner. We are prepared to provide that persistent capacity. Our Commandant has further stated that Ma- rines, Active or Reserve Component, join the Marine Corps to do the things they are now doing—deploying and winning our nation’s battles. The nature of the fight in Afghanistan for instance, is particularly suited to our Marine Reserves. It is a thinking man’s fight that requires solutions at the grassroots level, where our Ma- rines operate best, among the population, as evidenced by our combat prowess in Iraq and humanitarian assistance today in Haiti. Our successes in Iraq were has- tened by the types of individuals we have in our ranks, who were utilizing civilian skills in ways not necessarily anticipated, but ultimately pivotal to the success in Al Anbar. That maturity, creativity and confidence is what an Operational Reserve brings to the fight. Your Marine Corps Reserve is more highly trained, capable, and battle-tested than at any time since the Korean War. As an integral part of the Total Force Marine Corps, it blends seamlessly into the gaining force regardless of whether Marines come as individual augments, detachments, or as operational units. As of January 31, 2010, more than 54,000 Reserve Marines have executed over 70,000 mobilizations in support of Overseas Contingency Operations (OCO) since September 11, 2001. The vast majority of these Marines deployed to the U.S. Cen- tral Command area of responsibility. One hundred percent of Marine Corps Reserve units at the battalion and squadron level have either been activated in their entirety or activated task-organized detachments. Again, the vast majority deployed to the U.S. Central Command area of responsibility. Without going into too many specifics, 4,000 Marines and sailors—citizens from Texas, California, Missouri, Nevada, Utah, Maryland and Virginia—from the 4th Marine Division deployed to both war zones and went a long way to achieving success in al Anbar Province, Iraq and training security forces in Afghanistan. Thousands of other Division Marines also deployed in support of Combatant Commander Theater Security Cooperation initiatives to South America, Eastern Europe, Asia, Africa, Australia, and various Pacific island nations. This year will be no different with exercises planned for Norway, Peru, Belize, Uganda, Estonia and Morocco, and again in various nations in Asia and the Pacific islands. Our Reserve aviators of the 4th Marine Aircraft Wing are no less busy supporting Marine and joint training requirements here in the United States, as well as deploying fighter and helicopter squadrons to the war zones and Horn of Africa, and supporting Combatant Commander initiatives across the globe as well. Of particular note the Total Force Marine Corps has had to rely heavily on the 4th Marine Air- craft Wing in support of the Marine Corps Aviation Transition Strategy. Modern- izing from, in some cases, 40 plus year-old legacy aviation systems, to the leap ahead capabilities inherent in the V–22 ‘‘Osprey’’ and the Joint Strike Fighter, we have had to temporarily transfer manpower, airframe, and support structure to the active component. Beginning in 2014, Marine Forces Reserve will commence the process of transitioning to the new systems and capabilities, but in the mean time is in total support of the overall Total Force modernization efforts. The third Major Subordinate Command of the Reserve Component is 4th Marine Logistics Group. Anyone who understands the Marine Air Ground Task Force (MAGTF) concept knows full well the ground fighters of the Division, and aviators of the Wing, go nowhere without the logistics professionals in the Group. In addition to service in both wars, and every one of the 57 events—large and small—that have contributed so mightily to all the Combatant Commanders’ efforts across the globe, there were two special endeavors I want to highlight. The first was the command element’s service as operational logistic providers in the Korean Theater last April during exercise KEY RESOLVE, made necessary by a dearth of joint logistics capability due to the demands of Iraq and Afghanistan, and particularly the additional expeditionary demands of transitioning Marine forces in large numbers out of Iraq and into Afghanistan. The second is the increased support provided to various Mari- 308 time Prepositioning Exercises, again made necessary by wartime demands experienced by the Total Force. Unique inside the Marine Corps is the Mobilization Command (MOBCOM), of Ma- rine Forces Reserve. As the increased use of the Individual Ready Reserve (IRR) has grown over the last several years, so too has the workload of Mobilization Com- mand. During the last fiscal year, more than 900 sets of mobilization orders were issued with a total of 653 IRR Marines reporting for activation. MOBCOM also processed more than 9,400 sets of shorter duration orders. Mobilization Command developed and participated in family readiness programs that are particularly difficult within the IRR construct. Initiatives like the Congressionally-mandated ‘‘Yellow Rib- bon Programs’’ seek to provide support to families from initial call up through return and demobilization. Additionally, Mobilization Command conducted regional IRR musters, often partnering with other government agencies like the Department of Veterans Affairs, to maintain required annual contact with Marines once they have left active service but still ‘‘owe’’ the Nation reserve time. Let me touch again on one of the important planning mechanisms for an Oper- ational Reserve. Our Force Generation Model, developed and implemented in Octo- ber 2006, continues to provide long-term and essential predictability of future activations and deployments. The Model provides my Marines, their families, and just as importantly their employers, the capability to plan their lives five or more years out. It enables them to strike the critical balance between family, civilian career, and service to the Nation, while allowing employers time to manage the loss of valued employees. The Force Generation Model also assists service and joint force planners in maintaining a consistent and predictable flow of fully capable Marine Corps Reserve units. Internal to the Marine Corps this flow of fully trained and capable Reserve units has proven essential in reaching the Secretary of Defense established target of a 1:2 dwell for our Active Component. The Model is a relatively simple management tool based on 1-year activations, to 4-plus years in a non-activated status. This makes continued programmed utilization of the Reserve Component sustainable at 1:5 over the long term and supports the momentum about which I spoke in my introduction. Predictable activation dates, mission assignments and geographical destination years out now permits me to orient training on core mission requirements early in the dwell period, then transitioning training focus to specific mission tasks once the unit is 12–18 months from activation. In each of the past 3 years, between the wars in the Middle East and South Asia, and theater security cooperation activities to include mobile training teams conducting ‘‘Phase Zero’’ operations, nearly one-third of our 39,600 Marines have deployed outside the continental United States both in an activated and non-activated status. In fiscal year 2009 alone, 7,500 Marines were activated and deployed in support of the war in Iraq and Afghanistan, and an additional 5,800 were sent overseas to many locations on several continents in support of joint and combined theater security cooperation exercises. For the second year in a row Marine Forces Reserve stateside will sponsor exercise ‘‘Javelin Thrust’’ in June focusing on Marine Air-Ground Task Force (MAGTF) core competency training. The scenario of this year’s event is tailored to the current operating environment, and participating units have been identified consistent with their future deployment schedule as defined by the Force Generation Model. The end state of the exercise (Javelin Thrust) is that the headquarters staffs of the participating organizations (regiments, aircraft groups, battalions, and squadrons) are prepared for activation and are provided an in-depth roadmap to guide future pre- activation training. Additionally, individuals serving on those staffs will receive training allowing them to take their place as individual augments on a MAGTF or joint staff overseas, while other individuals in those units will be prepared for activation and the conduct of pre-deployment training. Last year’s Javelin Thrust was the first large scale MAGTF exercise involving all three Major Subordinate Com- mands (Division, Wing and Marine Logistics Group) in 6 years. The 2009 distributed operations Afghan scenario also allowed other Department of Defense agencies to participate and to test advanced technologies and transformational concepts. This year’s exercise will also be conducted aboard installations throughout the Western United States with both virtual and real world aspects to the exercise.

PERSONNEL The Selected Marine Corps Reserve is comprised of Marines in reserve units, those in Active Reserve status, Individual Mobilization Augmentees, and those in initial training. When taken together, these various categories of Marines form the 309 inventory of the 39,600 authorized end strength in the Selected Marine Corps Re- serve. Although we continue to enjoy strong volunteerism there has recently been some slight degradation in our ability to maintain authorized end strength. We were above 100 percent of our authorized end strength during fiscal years 2002–2005. There was a very slight drop to 99.71 percent in fiscal year 2006. In fiscal years 2007 and 2008 percentages of authorized end strength dropped to 97.36 and 94.76 percent—shortfalls of 1,044 and 2,077 individuals—respectively. This past fiscal year (2009), end strength improved to 97.25 percent. This is within the mandated 3 percent of authorization. When the 138 Marines who had served on active duty for more than 3 of the last 4 years were taken into account, our shortfall increased to 3.1 percent (1,228). The dip below authorized strength experienced in 2007 and 2008 was predicted at the time due in large measure to the pressure put on the recruiting and retention of individuals to serve in the active force as the Marine Corps built to 202,000 active duty Marines. Now that the 202,000 goal has been met and surpassed well ahead of schedule, we are now institutionally focusing on Re- serve recruiting and retention efforts to maintain required Reserve Component end strength. The bonus and incentive programs that you provide for recruiting and retention will remain essential tools to continue achieving this goal. The Total Force Marine Corps will undoubtedly continue to rely heavily upon augmentation and reinforcement provided by Marine Forces Reserve. I believe our authorized end strength of 39,600 is still an appropriate number and will consequently drive recruiting and retention. This number provides us with the Marines we require to support the Force, and achieve the Commandant’s goal of a 1:5 deployment- to-dwell ratio in the Selected Marine Corps Reserve. The Marine Corps-Navy Reserve Team is as strong as ever. In the past year the Navy ensured Marine Reserve units were fully manned and supported with Pro- gram 9 (U.S. Navy personnel in support of Marine Forces) and HSAP (Health Serv- ice Augmentation Program) personnel during all phases of the deployment (pre, operational, post). More than 500 Navy personnel were sourced to staff Marine Forces Reserve units deploying to Iraq and Afghanistan, as well as numerous joint/ combined exercises. These individuals focused almost entirely on providing medical, dental and religious services. The Navy Mobilization Office works with my headquarters, as well as with the four major subordinate commands, sourcing 100 percent of all requirements. As the demand increases throughout the forces, Program 9/HSAP support commands a high level of attention to fulfill not only Marine Corps missions, but Army and Navy missions as well. I am confident this process will continue ensuring Marine Forces Reserve units are supported with qualified Program 9 and HSAP personnel to accomplish the mission. The Marine Corps is unique in that all recruiting efforts—officer, enlisted, Active and Reserve Component, and prior-service—fall under the direction of the Com- manding General, Marine Corps Recruiting Command. This approach provides tremendous flexibility and unity of command in annually achieving Total Force recruiting objectives. Like the Active Component, Marine Corps Reserve units rely primarily upon a first-term enlisted force. Recruiting Command achieved 100 percent of its recruiting goal for non-prior service recruiting (4,235) and prior service recruiting (4,501) in fiscal year 2008. It also exceeded its recruiting goal for non-prior service recruiting (5,296) and exceeded 100 percent of its goal for enlisted prior service recruiting (3,862) during fiscal year 2009. As of January 31, 2010, 2,359 non- prior service and 1,397 enlisted prior service Marines have been accessed, reflecting 46 percent of the annual enlisted recruiting mission for the Selected Marine Corps Reserve. We fully expect to meet our Selected Marine Corps Reserve recruiting goals again this year. The Selected Marine Corps Reserve Affiliation Involuntary Activation Deferment Policy was implemented during June 2006. The policy allows a Marine who has recently completed a deployment with an active unit an option for a 2-year deferment from involuntary activation if they join a Selected Marine Corps Reserve once they leave active duty. The intent of the 2-year involuntary deferment is to allow transitioning Marines the opportunity to participate in the Selected Marine Corps Reserve, while at the same time giving them a break and an opportunity to start the process of building their new civilian career. Officer recruiting remains our most challenging area. Historically, the Active Component has been the exclusive source of lieutenants and captains for the Re- serves. This arrangement has paid tremendous dividends. Responding to the critical challenge of manning the Reserves with quality company grade officers, we have implemented three commissioning initiatives that focus exclusively on officer accessions for the Reserve Component: Reserve Enlisted Commissioning Program (expanded to qualified active duty enlisted Marines as well); Meritorious Commis- 310 sioning Program—Reserve (open to individuals of either component holding an Asso- ciates Degree or equivalent in semester hours); Officer Candidate Course—Reserve (OCC–R). Since 2004 these three programs have produced a total of 190 lieutenants for the Reserves with OCC–R being the most successful of the three, producing 161 officers. The program focuses on ground billets with an emphasis on ground combat and combat service support and within specific Reserve units that are scheduled for mobilization. The priority to man units with these officers is once again tied to the Force Generation Model. All commanders and senior enlisted leaders across the force are tasked to retain quality Marines through example, information and retention programs, and mentoring. This takes place across the Marine experience and not just in the final days of a Marine’s contract. For those approaching the end of their current contracts— Active or Reserve Component—they receive more focused counseling on the tangible and intangible aspects of remaining associated with, or joining, the Selected Marine Corps Reserve. With the Congress’ help, affiliation bonuses, officer loan repayment and other initiatives have effectively supported our efforts to gain and retain the very best. The Commandant and certainly all of us in Marine Forces Reserve, greatly appreciate the continuance of all of the many programs that help us recruit and retain the best young men and women this nation produces.

EQUIPMENT As mentioned previously we are as good today as we have been since at least the Korean War, if not World War II. This level of proficiency as warfighters is due, in large part, to the amount and frequency of combat the reserve forces have accumulated over the past 9 years while serving as an operational reserve. In addition, the quality of our equipment is on par with that of the active duty. Therefore, it is imperative we spend the relatively small amount required to maintain our operational reserve and provide a reasonable return on that investment. The end result is a better trained and more capable force than ever operating alongside our active duty brethren on the ground, in the air, and at sea. To achieve and maintain this high level of readiness and proficiency we have like all of DOD relied heavily on supplemental funding in the Overseas Contingency Operational account. As we move forward it is in the best interests of the nation to not lose these historically high levels of proficiency. The current strong and operationally competent Reserve Component has cost us much in lives and budgetary treasure to achieve over the last 9 years. As part of the Total Force, Marine Forces Reserve has two primary equipping priorities. The priority is to equip units and individuals set to deploy, and the second is to ensure units that are accomplishing normal training within the first 2–3 years of their dwell cycle have what they need in training allowance. We will always continue to provide those next into the fight all that they need in the latest generation of individual combat and protective equipment, and unit suites, to fight, accomplish the mission, and come home with the fewest number of casualties possible. Those not as close to deploying overseas to combat will also continue to be equipped with the best of everything and tailored specifically to whatever is next in their lives as defined by the Force Generation Model. The Marine Corps approaches equipment procurement and fielding from a Total Force perspective with the Reserve Component treated in exactly the way as the three active operational Marine Forces organizations. In many cases we have achieved lateral fielding when Active and Reserve Component organizations are receiving equipment sets simultaneously. Again, fielding is prioritized by who is next to the fight. If they need it to train with post-deployment, they have it, otherwise in some cases they will pick it up in theater in the normal transfer of equipment that has marked the way the Marine Corps has done business since 2003. The National Guard and Reserve Equipment Appropriation (NGREA) allows me to mitigate any equipment deficiencies here in CONUS. For fiscal year 2009, Marine Forces Reserve received two sources of NGREA funding totaling $62.4 million. By providing the flexibility to purchase or accelerate the fielding of mission essential equipment, our units are better trained during pre-deployment and integrate effectively once they get in theater. As the Commandant consistently states, our number one focus will be the individual Marine and Sailor in combat. Ongoing efforts to equip and train this most valued resource have resulted in obtaining the latest generation individual combat and protective equipment: M16A4 service rifles, M4 carbines, Rifle Combat Optic scopes, Lightweight Helmets, enhanced Small Arms Protective Insert plates, Mod- ular Tactical Vests, and the latest generation Flame Resistant Organizational Gear 311

(FROG.) Every member of Marine Forces Reserve has deployed fully equipped with the most current authorized Individual Combat Clothing and Equipment to include Personal Protective Equipment. The decisions regarding what they deploy with are made by commanders with a great deal of combat experience, and nothing is left to chance. However, as personal protective equipment has evolved over the years of this conflict there is now so much equipment and it is so heavy that the way we fight is adversely impacted. In particular the infantrymen are so heavy, in some cases carrying more than 100 pounds of equipment; they are more beasts of burden than they are agile hunters. It is not simply a matter of reducing the weight of individual items as these only add up to marginal weight savings, but hard decisions about what they carry and how much they carry are essential. The Commandant’s unit equipping priority for Marine Corps Reserve units inside their dwell periods is to provide sufficient equipment to train with, but not burden the organizations with so much gear that they use all of their training time or unit funds maintaining it. We call this a reserve unit’s Training Allowance (TA.) This TA is the amount of equipment required by each unit to conduct home station training. Our goal is to ensure that the Reserve TA contains the same equipment utilized by the active component. It is imperative that our units train with the same equipment they will utilize while deployed. The Marine Corps Reserve maintains a training allowance at each of its reserve centers. As a whole, we are adequately equipped to effectively conduct training. NGREA funding from 2009 continues to be used to purchase much needed Light Armored Vehicles, ruggedized command and control laptops, aircraft systems and survivability upgrades and continued procurement of the Logistics Vehicle Replace- ment System Cargo variant. Marines are exceptionally good stewards of American taxpayer dollars, and the public property procured by those monies. In order to sustain an inventory of current equipment necessary to conduct home station training several resources and programs are utilized. The first is the routine preventive and corrective maintenance performed locally by user and organic maintenance personnel. Second, we have expanded ground equipment maintenance efforts, which rely largely on contracted services and depot-level capabilities. Third is our reliance on Marine Corps Logistics Command mobile maintenance teams providing preventive and corrective maintenance support to all 183 Marine Reserve sites across the nation. This partnership provides a uniquely tailored Repair and Return Program. Fourth, we are intimately involved in the Marine Corps Enterprise Lifecycle Maintenance Program rebuilding and modifying an array of principal end items as required. Finally, we field the Corrosion Prevention and Control Program. Cumulatively all of these initiatives have resulted in a Marine Forces Reserve ground equipment readiness rate of 97 percent. Our 4th Marine Aircraft Wing ‘‘mission capable’’ rate in 2009 was 73 percent which is consistent with recent year rates and with the Active Component rate of 71 through November 2009.

TRAINING The reality today is that the Reserve Component has transitioned from what was considered a strategic reserve, to what is today the ‘‘operational reserve.’’ Forever gone are the days when Reserve Marines were considered mere ‘‘weekend warriors’’ and held in reserve to reinforce the active force when it experienced catastrophic casualties from a World War III scenario against the former Soviet Union. For the last 9 years our Reserves have been a fully integrated force, routinely deployed to fight in Iraq and Afghanistan, and to execute theater cooperation engagement operations around the world at the behest of the combatant commanders. From all of these experiences we have captured important lessons that we have put to immediate use in improving every facet of our training. In this regard, one of the most exciting areas where we are continuing to transform the depth and scope of our training remains the cutting-edge arena of Modeling and Simulations Technology. Marine Forces Reserve is fielding several immersive complex digital video-based training systems, complete with the sights, sounds and chaos of today’s battlefield environments. These systems are particularly important considering the limited training time and facilities available to our commanders. Last year we completed the fielding and upgrading of the Indoor Simulated Marksmanship Trainer-XP (ISMT). These simulators make it possible for the Marines to ‘‘employ’’ a variety of infantry weapons (pistols through heavy machineguns) in rifle squad scenarios. These simulators now serve as regional training centers and more are planned. The Virtual Combat Convoy Trainer-Reconfigurable Vehicle System provides invaluable pre-deployment training for the drivers or all makes and models of tactical vehicles. The conditions of terrain, road, weather, visibility and vehicle condition can all be 312 varied, as can the combat scenario (routine movement, ambush, IED, etc.) The simulator is a mobile, trailer-configured platform that utilizes a HMMWV mock-up, small arms, crew-served weapons, 360-degree visual display with after-action review/instant replay capability. We are now preparing to accept the fourth generation of this system, with student throughput doubling. Another simulation technology being fielded is the Deployable Virtual Training Environment (DVTE.) The DVTE also provides small-unit echelons with the opportunity to continuously review and rehearse command and control procedures and battlefield concepts in a virtual environment. All of this provides individual, fire team, squad and platoon-level training associated with patrolling, ambushes and convoy operations. Additional features include supporting arms upgrades (for virtual combined arms indirect fire and forward air control training), combat engineer training, small-unit tactics training, tactical foreign language training and event- driven, ethics-based, decisionmaking training. It is important to recognize the key role Congress has played in the fielding these advanced training systems, all of which have been rapidly acquired and fielded with supplemental and NGREA funding.

FACILITIES Marine Forces Reserve is comprised of 183 sites in 48 states, the District of Co- lumbia, and Puerto Rico. These facilities consist of 32 owned sites, 151 tenant locations, 3 family housing sites, and a Marine barracks. In contrast to Active Duty installations that are normally closed to the general public, our reserve sites are openly located within civilian communities. This arrangement requires close partnering with state and local entities nationwide. Thus, the condition and appearance of our facilities may directly influence the American people’s perception of the Marine Corps and the Armed Forces. Department of Defense policy and the use of standardized models for Marine Forces Reserve Facilities Sustainment, Restoration, and Modernization (FSRM) dollars have greatly improved funding profiles for our Reserve Facilities over the last several years. We are experiencing some of the best levels of facility readiness due to increased funding in the last 3 years, complemented by the addition of $39.9 million in stimulus dollars from the American Recovery and Reinvestment Act of 2009. We have repaired and upgraded sites across the country with projects continuing to completion in 2011. Between the BRAC 2005 and our normal Military Construc- tion of Naval Reserve (MCNR) Program, we will have replaced over 35 of our 183 Reserve Centers in the next 2 years. This represents the largest movement and upgrade in memory for the Marine Corps Reserve. MARFORRES research and investment for the last 2 years in energy efficiency, sustainability, and renewable energy is coming to fruition this fiscal year. Every new FSRM renovation project or MILCON is targeted for energy efficiency and sustainability aspects in accordance with policy and Leadership in Energy and Environ- mental Design (LEED) guidelines. We recently commissioned our first LEED Silver building at Camp Lejeune (the first in the Marine Corps) and are anticipating completion this year of our first LEED Silver rehabilitation project for 4th Combat Engi- neer Battalion in Baltimore, Maryland (a potential first for the Marine Corps as well). All of our MILCON projects from fiscal year 2009 on will comply with directives to achieve LEED silver or higher as funding profiles allow. We will be conducting energy assessments of all our 32 owned sites this fiscal year along with preparation of smart metering technology for each to enhance conservation and management. The MARFORRES approach combines efficiency, conservation, and renewable aspects to achieve optimal return on investment. We have six active solar projects underway this year with all coming on line within the next 12 months. Our six wind turbine projects are under suitability and environmental evaluations. If findings support, they will start coming on line within 18 months at an anticipated payback of as little as 8 years. Marine Forces Reserve is working with the National Renewable Energy Lab to produce a sound renewable energy plan for all Marine Forces Reserve locations. Our investment and implementation of these technologies provides energy security, efficiency, and cost avoidance for our dispersed sites. The visibility of our projects in heartland of America and cities across the nation provides tangible evidence of our commitment to the future. Marine Forces Reserve Facilities Sustainment, Restoration, and Modernization (FSRM) program funding levels continue to address immediate maintenance requirements and longer-term improvements to our older facilities. Sustainment funding has allowed us to maintain our current level of facility readiness without further facility degradation. Your continued support for both the MCNR program and a strong FSRM program are essential to addressing the aging infrastructure of the 313

Marine Corps Reserve. The MCNR program for exclusive Marine Corps construction must effectively target limited funding to address at least $132 million in deferred construction projects of our aging infrastructure. Increases in our baseline funding over the last 6 years have helped to address these deferred projects substantially. Over 27 percent of the reserve centers our Marines train in are more than 30 years old and of these, 55 percent are more than 50 years old. Past authorizations have improved the status of facilities in the 30 to 50 year range and continued investment will allow for further modernization. The $35 million in additional MCNR funding this fiscal year has allowed MARFORRES to commence several additional projects. The Base Realignment and Closure (BRAC) 2005 continues to move forward and the Marine Corps Reserve will relocate 12 units to consolidated Reserve centers this fiscal year. Marine Forces Reserve is executing 25 of the Marines Corps’ 47 BRAC directed projects to include the only closure; Mobilization Command in Kansas City Missouri, is moving to New Orleans, Louisiana. Of these 25 BRAC actions, 21 are linked to Army and Navy military construction projects. Our BRAC plans are tightly linked to those of other services and government agencies as we develop cooperative plans to share reserve centers and coexist in emergent joint bases such as Joint Base Maguire-Dix-Lakehurst. All remaining Marine Corps Reserve BRAC projects are on track for successful completion with the directed timelines for closure. Of special note is the movement of Headquarters, Marine Forces Reserve and consolidation of its major subordinate commands in New Orleans. This unique BRAC project, integrating state, local and Federal efforts, is now well underway for the new headquarters compound and tracking for on time completion. The state of Lou- isiana is providing construction dollars for the new headquarters facility and saving the Federal government more than $130 million. The Department of the Navy is providing the interior finishings and security infrastructure in accordance with the lease agreement. This building will incorporate multiple energy and environ- mentally friendly processes to meet LEED certifiable standards. Marine Forces Re- serve is working with the Department of Energy’s Federal Energy Management Pro- gram to maximize the sustainability and energy efficiencies of the buildings and compound. Upon completion and certification, this building and its surrounding acreage will become the newest Marine Corps Installation: Marine Corps Support Facility, New Orleans. Our Marine Forces Reserve Environmental Program employs the Environmental Management System (EMS), which uses a systematic approach to ensure that environmental activities are well managed and continuously improving. Additionally, Marine Forces Reserve has initiated a nationwide program to reduce hazardous waste production and ensure proper disposal at our centers. Our Green Box Battery Program was responsible in fiscal year 2009 for recycling over 2 tons of various types of batteries alone. MARFORRES Environmental undertook steps to replace the recycling equipment with completely operable, fully recycling systems. Through fiscal year 2009, wash rack recycling systems at 16 reserve center sites have been replaced. This project has saved over 650,000 gallons of water and cost savings of $500,000, not to mention the enhanced risk avoidance to our national water infrastructure. Marine Forces Reserve is updating all environment baseline surveys of our owned sites to ensure we are current in all aspects of caring for our nation’s resources.

HEALTH SERVICES The most important part of any Marine organization is of course the Marines, Sailors, Civilian Marines and families who shoulder the burden of defending our country every day. Taking care of them is a sacred trust. This begins with arduous training for combat, and equipping them with the best equipment in the world to do the job once deployed to the fight. It then extends to providing the best healthcare possible to them and their loved ones. Our routine health services priority is to attain and maintain Individual Medical and Dental Readiness goals as set by the Department of Defense. In 2009, individual medical and dental readiness for our Marines and sailors was 68 percent and 77 percent respectively. This represents a 5 percent improvement over the previous year. The Reserve Health Readiness Program (RHRP) is the cornerstone for individual medical readiness. This program funds contracted medical and dental specialists to provide healthcare services to units specifically to increase individual medical and dental readiness. In the near term Navy medicine supports through various independent contracted programs such as the Post Deployment Health Reassessment (PDHRA), and the Psychological Health Outreach Program. The first identifies health issues with specific emphasis on mental health concerns which may have 314 emerged since returning from deployment, while the Psychological Health Outreach Program addresses post deployment behavioral health concerns through a referral and tracking process. Worthy of mention in the area of mental health is our full participation in a very recent initiative designed and ruthlessly monitored by our Commandant and Assistant Commandant, in an effort to get at the tragedy of suicide. Our Warrior Preservation Program, run by senior staff officers and non-commissioned officers has trained 239 instructors who will return to their home units and reinforce the important lessons they received. We conducted training for all of our personnel at each of our units and I have as the Commander, filmed my own message on this topic and prominently displayed it on our public website. TRICARE remains a key piece of our medical support programs, providing medical, dental and behavioral health services. Members of the Selected Reserve qualify for and may enroll in TRICARE Reserve Select, which provides TRICARE Standard coverage until the member is activated. While on military duty for 30 days or less a Reservist who does not choose TRICARE Reserve Select coverage is covered under Line of Duty care. Upon activation, and during any applicable early identification period, the Reservist is covered by TRICARE Prime and may choose to enroll eligible family members in TRICARE Prime, Prime Remote or Standard. When deacti- vated, a Reservist who mobilized in support of overseas contingency operations is eligible for 180 days of TRICARE transitional health plan options. With your support these DOD programs will continue to provide Reservists and their family members’ important medical benefits as they transition on and off active duty status.

QUALITY OF LIFE Our Commandant has affirmed that our Corps’ commitment to Marines and Sail- ors in harm’s way extends to their families at home. As part of Marine Corps reforms to enhance family support, we are placing full-time Family Readiness Officers (FROs), staffed by either civilians or Active Duty Marines, at the battalion/squadron level and above to support the Commandant’s family readiness mission. As you might imagine an organization spread across the nation and overseas has unique challenges, but communication technologies, improved procedures and processes have worked to more effectively inform and empower family members including spouses, children and parents who often have little routine contact with the Marine Corps and live far from large military support facilities. The installation of full-time Family Readiness Officers at the battalions and squadrons bridges many gaps and overcomes many challenges unique to the reserve component. It is a low cost solution with a significant return on investment and I urge the continued support of this critical program. We fully recognize the strategic role our families have in mission readiness, particularly with mobilization preparedness. We prepare our families for day-to-day military life and the deployment cycle by providing education at unit family days, pre-deployment briefs, return and reunion briefs, and post-deployment briefs. To better prepare our Marines and their families for activation, Marine Forces Reserve is fully engaged with OSD to implement the Yellow Ribbon Reintegration Program, much of which we have had in place for quite some time. We are particularly supportive of Military OneSource, which provides our reservists and their families with an around-the-clock information and referral service via toll-free telephone and Internet access on subjects such as parenting, childcare, education, finances, legal issues, deployment, crisis support, and relocation. Through the DOD contract with the Armed Services YMCA, the families of our deployed Reserve Marines are enjoying complimentary fitness memberships at participating YMCA’s throughout the United States and Puerto Rico. Our Active Duty Marines and their families located at Independent Duty Stations have access to these services as well. The Marine Forces Reserve Lifelong Learning Program continues to provide educational information to service members, families, retirees, and civilian employees. More than 1,100 Marine Forces Reserve personnel (Active and Reserve) enjoyed the benefit of Tuition Assistance, utilizing more than $3 million that funded more than 3,900 courses during fiscal year 2009. The Marine Corps’ partnership with the Boys and Girls Clubs of America (BGCA) and the National Association for Child Care Re- sources and Referral Agencies (NACCRRA) continues to provide a great resource for service members and their families in accessing affordable child care, before, during, and after a deployment in support of overseas contingency operations. We also partnered with the Early Head Start National Resource Center Zero to Three to expand services for family members of our Reservists who reside in isolated and geographically-separated areas. 315

Managed Health Network (MHN) is an OSD-contracted support resource that provides surge augmentation counselors for our base counseling centers and primary support at sites around the country to address catastrophic requirements. The Peacetime/Wartime Support Team and the support structure within the Inspector- Instructor staffs at our reserve sites provide families of activated and deployed Ma- rines with assistance in a number of support areas. Family readiness directly impacts mission readiness and your continued support of these initiatives is deeply appreciated.

CASUALTY ASSISTANCE AND MILITARY FUNERAL HONORS Casualty assistance remains a significant responsibility of active component Ma- rines assigned to our Inspector-Instructor and Site Support staffs. Continued operational efforts in Afghanistan and Iraq have required that these Marines remain ready at all times to support the families of our Marines fallen in combat abroad or in unforeseen circumstances at home. By virtue of our geographic dispersion, Ma- rine Forces Reserve personnel are best positioned to accomplish the vast majority of all Marine Corps casualty assistance calls and are trained to provide assistance to the family. Historically, Marine Forces Reserve personnel have been involved in approximately 90 percent of all Marine Corps casualty notifications and follow-on assistance calls to the next of kin. There is no duty to our families that we treat with more importance, and the responsibilities of our Casualty Assistance Calls Of- ficers (CACOs) continue well beyond notification. We ensure that our CACOs are adequately trained, equipped, and supported by all levels of command. Once a CACO is designated, he or she assists the family members in every possible way, from planning the return of remains and the final rest of their Marine to advice and counsel regarding benefits and entitlements. In many cases, our CACOs provide a permanent bridge between the Marine Corps and the family, and assist greatly in the process of grieving. The CACO is the family’s central point of contact and support, and is charged to serve as a representative or liaison to the media, funeral home, government agencies, or any other agency that may become involved. Additionally, Marine Forces Reserve units provide significant support for military funeral honors for our veterans. The active duty site support staff members, with augmentation from their Reserve Marines, performed more than 12,700 military funeral honors in 2009 (91 percent of the Marine Corps total). We anticipate providing funeral honors to more than 13,000 Marine veterans in 2010, even as projected veteran deaths slowly decline. Specific authorizations to fund Reserve Marines in the performance of military funeral honors have greatly assisted us at sites such as Bridgeton, Missouri, Chicago, Illinois, and Fort Devens, Massachusetts, where more than 10 funerals are consistently supported each week. As with Casualty Assist- ance, we place enormous emphasis on providing timely and professionally executed military funeral honor support.

CONCLUSION Your Marine Corps Reserve is operational and fully committed to train and execute the Commandant’s vision for the Total Force. The momentum gained over the past 9 years, in Iraq, Afghanistan and in support of theater engagements around the globe remains sustainable through coordinated focus, processes and planning. In everything we do, we remain focused on the individual Marine and Sailor in combat. Supporting that individual requires realistic training, proper equipment, the full range of support services and professional opportunities for education, advancement and retention. That is our charge. You should know that the patriots who fill our ranks do so for the myriad reasons familiar to those who wear this uniform and those who sustain us. Yet reservists serve while balancing civilian careers and outside responsibilities, often at significant personal cost. Your continued unwavering support of the Marine Corps Reserve and associated programs is greatly appreciated. Semper Fidelis. Chairman INOUYE. General Stenner. STATEMENT OF LIEUTENANT GENERAL CHARLES E. STENNER, JR., CHIEF, AIR FORCE RESERVE General STENNER. Chairman Inouye and Vice Chairman Coch- ran, thank you very much for the opportunity to be here today. And as I start, I’d like to introduce my Air Force Reserve Com- mand Command Chief, Chief Master Sergeant Dwight Badgett, who joins me here today in representing the 71,000 Air Force Re- 316 serve members, the large majority of whom are our enlisted force and are the backbone of what we do out there every day. And I would like to also state, as I start, that, most recently, I had an opportunity to take a trip through the area of operations and stop at some places in both Afghanistan and Iraq. One of the stops I made was at Kandahar. And at Kandahar, we had an opportunity to talk to some of our engineers, our explosive ordnance disposal folks, and go through what kinds of things they were doing just coming back from missions, just going to missions. And, of course, along the way, we always have the photog- raphers, and we take the pictures. And as I returned home, 3 days later I received a picture of one of the individuals on explosive ordnance detail (EOD) who I had just chatted with, along with the notice that he had been killed on a route patrol in clearing some of the IEDs that had been along the way. I will tell you, sir, that as I met his family on my return, that it really hits home that we have a sacred pact with this Nation to sustain and maintain these valuable resources that we have that we call citizen warriors in each and every one of our services. So, that brought home to me that I need to continue with all effort, along with you and your subcommittee, in making sure that we are ready and we are capable in the jobs that we have. And in the Air Force Reserve, we are part of every mission set in the Air Force. We share those missions with our Active Duty and our Guard partners. And in two perspectives I’d like to talk real quick about readiness and readiness that goes to training and equipping. The training piece of this readiness—and since I last talked to you and introduced what we called a ‘‘Seasoning Training Program’’—has been extremely successful. We have used some of the dollars that you have allocated to take our brand new folks who we have been recruiting, putting through tech school. After tech school, we take them into a continued training program, as opposed to a monthly program, and have, in fact, been able to, in most cases, reduce by 18 to 24 months the time at which they become combat ready and combat capable, thereby getting them to the fight earlier. We’re going to continue in that vein with that Seasoning Training Pro- gram, accelerate that. And if those folks have the availability, I want to get them to the war, and they want to be there, and our retention is much higher on the folks who have been able to go do the things that they have signed up to do as those volunteer warriors. The other part of this readiness piece is, of course, equipping. And we’ve talked a lot about that. The National Guard and equipment (NGREA) dollars are extremely important to all of us. In our case, we’ve looked at the precision engagement equipment, we’ve finished our buys on some of the pods. Our gear gets to the fight, it’s able to be used. We’ve accelerated those buys of our defensive systems on our large aircraft, and thereby get that equipment U.S. Central Command equipment to the area of responsibility (AOR), as well, much earlier. And then, along the way, we’ve got the irregular warfare fight that we are all fighting. And we’re looking at the personal protective gear—the body armors, the helmets, and the goggles that go 317 along with those. We’re accelerating those and making sure that, as we partner with our Active Duty and Guard partners, that we have the same equipment, so we have it at the same time, so we train with the same equipment and then can deploy, seamlessly integrated, as you have noted, throughout the area of operations. Let me finish with what I see—again, back to my sacred bond with this Nation is to make sure that we sustain and maintain that Strategic Reserve, which I believe we are, first and foremost. I leverage that Strategic Reserve on a daily basis to provide that operational force around this world in every single mission set that the Air Force has. I want to be at every location that the Active force is. So, when somebody makes a life-changing decision, I can capture that talent; I put them to work in the Air Force Reserve. I will offer them to the Army Guard and the Army Reserve and our other partners up here, as well. We just need not to lose that talent when they have a change in their life. At that point, I want to make sure I know where all of our folks are. I want to make sure I know where all that talent is. And I need to manage that such that we can be sustainable and predictable. And I’m working very hard with our Air Force to change the way we mobilize, to streamline that process, to make it much more efficient and effective across all of the expeditionary combat support and the operational arms that we have, to make sure that we get to the warfighter that package of capability they need to continue the fight we’ve got in every combatant command in the world today. I am committed to doing that. I’m committed to the readiness of this particular Air Force Reserve. I’m committed to sustaining these folks at the highest state so we can seamlessly integrate and holistically look across our entire enterprise to ensure that we do sustain that force in a predictable fashion, taking care of the family, the member, and their employer at the same time. PREPARED STATEMENT I look forward to your questions, sirs, and thank you for your support. [The statement follows:]

PREPARED STATEMENT OF LIEUTENANT GENERAL CHARLES E. STENNER, JR. Mr. Chairman and distinguished members of the Committee, I appreciate the opportunity to appear before you today and discuss the state of the Air Force Reserve. The 21st century security environment requires military services that are flexible—capable of surging, refocusing, and continuously engaging without exhausting their resources and people. Moreover, the 21st century fiscal environment is becoming ever-more constrained as threats by rising nations and pressing national interests compete for limited resources. In this challenging environment, the Air Force Reserve has never been more relevant. Reserve Airmen continue to support our Nation’s needs, providing superb operational capability around the globe. We have sustained this operational capability for nearly 20 years—at high operations tempo for the past 9 years. The Air Force Reserve is accomplishing this while still providing a cost-effective Tier 1 ready force to the Nation available for strategic surge or ongoing operations. Speaking of ongoing operations, U.S. Air Force C–130 aircrews were among the first U.S. military to respond to the earthquake disaster in Haiti, on the ground in Port Au Prince within 24 hours of the earthquake. This quick response was not simply fortuitous, but the result of planning, preparedness, and readiness. This rapid- 318 response capability is available 24/7, 365 days a year through Operation Coronet Oak.1 Since 1977, the Operation Coronet Oak mission has been manned primarily by Air Force Reserve and Air National Guard crews who rotate every 2 weeks, year- round. Crews from the Regular Air Force now perform about one-third of the mission. These Operation Coronet Oak crews are postured to respond within 3 hours of notification to any crises requiring airlift support within the U.S. Southern Com- mand Area of Responsibility (AOR). This predictable-rotational mission allows Reservists to perform real-world operational missions and still meet their obligations to their full-time civilian employers. And, like Air Expeditionary Force (AEF) rotations, this operation leverages the Tier 1 readiness of Air Force Reserve Airmen in a way that works for the Combatant Commander, and the Reservist. Equally important, when Air Force Reserve Airmen are not training or performing an operational mission—they are not being paid; yet they remain ready to respond to any crisis within 72 hours should they be called upon. In this resource-constrained environment in which manpower costs are placing downward pressure on our budgets, I believe this full-time readiness/part-time cost is a great use of taxpayer dollars. This next year brings new challenges and opportunities. Air Force Reserve Air- men are being integrated into a wider variety of missions across the full spectrum of Air Force operations. Indeed, the Department of Defense (DOD) is considering using Reservists from all services to perform missions utilizing their unique civilian skill sets. The challenges we face are not unique to the Air Force Reserve or the Air Force as a whole. Each of the military services is being asked to shift capability and capacity across the spectrum of conflict—including irregular warfare—and to resource accordingly. Each has been asked to shift focus away from major weapon systems acquisitions and to the current fight.2 To do so, all three components of the Air Force must continually strive to improve the capability provided to the warfighter. Each service component must examine its existing business practices and explore new processes to make optimal use of personnel, platforms, and monetary resources. The Air Force Reserve is helping lead the way in improving Air Force capability as we approach fiscal year 2011 and beyond. As the Nation looks for ways to strengthen its organizations and integrate all of the untapped resources it will need in facing the challenges of the 21st century, we submit that a model by which ordinary people, dedicated to serving their country in ways that meet both their needs and the needs of the Nation, is already manifest in the U.S. Air Force every day—in the extraordinary Americans of the Air Force Reserve. I’m proud to serve alongside these great Airmen and as Chief and Commander of the Air Force Reserve, I have made a promise to them that I will advocate on their behalf for resources and legislation that will allow them to serve more flexibly in peace and war with minimum impact to their civilian careers, their families and their employers. I will work to eliminate barriers to service, so that they can more easily serve in the status that meets their needs and those of the Air Force. And, I will work to efficiently and effectively manage our Air Force Reserve to meet the requirements of the Joint warfighter and the Nation.

RECRUITING AND RETENTION Over the last 9 years, the Air Force Reserve has exceeded its recruiting goals and is on track to meet fiscal year 2010 recruiting and end-strength goals. Our success in great part has been due to the accessions of experienced Active Component members upon completion of their active duty commitments. Indeed, recruiting highly trained individuals is essential to lowering the training costs for the Air Force Re-

1 In addition to Haitian relief support through Operation Coronet Oak, Air Force Reserve ISR personnel provided exploitation support to assess the damage and focus relief while Air Force Reserve airlift crew saved lives with much needed medical, water and food supplies flown into Haiti. Air Force Reserve members in fact planned, commanded and exploited Global Hawk derived exploitation missions in order to provide situational awareness on infrastructure status and guide relief efforts during one of the worst earthquakes to hit Haiti on over 200 years. The professional expertise and capabilities of these seasoned Citizen Airmen demonstrates the flexibility and service inherit in the men and women of the Air Force Reserve as they shifted from supporting combat operations to humanitarian relief. 2 In Operations Enduring and Iraqi Freedom, Reserve C–130 crews flew over 9,800 hours in fiscal year 2009; Reserve F–16 and A–10 crews flew over 5,400 hours. The Air Force Reserve provides 24 crews and 12 fighter aircraft to USCENTCOM in their regularly scheduled rotations for the close air support mission. 319 serve. For some of our most critical specialties, affiliation and retention bonuses have provided a greater return on investment versus recruiting non-prior service Airmen. However, due to lower Regular Air Force attrition rates, we no longer have the luxury of large numbers of experienced Airmen leaving Active service. As the Air Force Reserve builds end strength to meet the needs of new and emerging missions, we are facing significant recruiting challenges. Not only will the Air Force Reserve have access to fewer prior-service Airmen; but, we will be competing with all other services for non-prior service (NPS) recruits. In fact, our non- prior service recruiting requirement has nearly doubled since the end of fiscal year 2007. To improve our chances of success, we have increased the number of recruiters over the next 2 years. Air Force Reserve retention is solid with positive gains in all categories in fiscal year 2009, after rebounding from a slight annual drop from fiscal year 2006-fiscal year 2008. Both officer and enlisted retention are up; enlisted retention has returned to the fiscal year 2006 rate. Career Airman retention is at its highest level in the last five years. Some of this success can be attributed to implementing several retention-focused initiatives such as developing a wing retention report card tool and General Officer emphasis on retention during base visits. With Air Force Reserve retention at its best for the last 3 years, this renewed focus on retention is expected to ensure that rates continue on a positive trend. We can’t take all the credit for this success. Congress has generously responded to our requests for assistance with improved benefits such as the post-9/11 GI Bill, inactive duty training (IDT) travel pay, and affordable TRICARE for members of the Selected Reserve. To date, under the conditions of the post-9/11 GI Bill benefit, the Air Force Re- serve has processed over 4,400 transferability requests impacting nearly 7,000 dependents. Under the Individual Duty Training travel pay benefit, more than 5,100 Air Force Reservists have received this benefit. This has helped us address those critical duty areas where we have staffing shortages. Since October 2007 when the three-tier TRICARE plan was eliminated, the Air Force Reserve has seen an increase in covered lives from 4,541 to 14,982 through January 31, 2010, equaling a 330 percent increase in program usage. The current coverage plan has made TRICARE more accessible and affordable for members of the Selected Reserve at a critical time when healthcare costs are rising. In addition to these new benefits, the Air Force Reserve has taken advantage of the many tools that you have provided us including the bonus program, the Yellow Ribbon Pro- gram, and our Seasoning Training program. The Bonus program has been pivotal to recruiting and retaining the right people with the right skills to meet Combatant Commander warfighting requirements. The Air Force Reserve uses the Bonus Program to fill requirements on our ‘‘Critical Skills List.’’ Those skills are deemed vital to Air Force Reserve mission capability. Development of these skills usually requires long training courses and members who have these skills are in high demand within the private sector. We are able to offer a wide menu of bonuses for enlistment, reenlistment, affiliation, and health professionals. Our Yellow Ribbon Reintegration Office is up and running and fully implementing Department of Defense directives. Our program strives to provide guidance and support to the military members and their families at a time when they need it the most, to ease the stress and strain of deployments and reintegration back to family life. Since the standup of our program from August 2008 to December 2009, we have hosted 113 total events across 39 Wings and Groups. 4,515 Reservists and 3,735 family members attended these events reflecting a 67 percent program usage rate for members deployed during this timeframe. From event exit surveys and through both formal and informal feedback, attendees indicated positive impressions, expressing comments about feeling ‘‘better prepared, (and) confident following events.’’ Designed to build a ‘‘ready force,’’ our Seasoning Training Program allows recent graduates of initial and intermediate level specialty training to voluntarily remain on active duty to complete upgrade training. The results have been a larger pool of deployable Reservists at an accelerated rate through this program. As a force multiplier, seasoning training is ensuring the Air Force Reserve maintains its reputation for providing combat-ready Airmen for today’s joint fight. The Seasoning Training Program is also proving beneficial for recruiting, training, and retaining members in the Air Force Reserve. This program is a success story and one that we will build on in the next year. The Air Force Reserve is working hard to increase Reservists’ awareness of benefits and incentives associated with their service. Reservists are taking advantage of these programs because they are having their intended effect. These programs are 320

helping to create the sustainable and predictable lifestyle that our members need to continue to serve in the Air Force Reserve. I am confident that as we act on not only our Air Force Reserve priorities, but also on those of the Air Force and the Department of Defense with the continued support of this Committee and Congress, we will be able to continue to meet the needs of Combatant Commanders and the Nation with a viable operational and strategic Air Force Reserve.

MAINTAIN A STRATEGIC RESERVE WHILE PROVIDING AN OPERATIONAL, MISSION READY FORCE The Air Force Reserve is first and foremost a strategic reserve leveraged to provide an operational, mission ready force in all mission areas.3 Air Force Reserve Air- men accomplish this by training to the same standards and currencies as their Reg- ular Air Force counterparts. As indicated at the outset, Air Force Reserve Airmen continue to volunteer at high levels and provide superb operational capability around the globe, serving side by side with the joint team. These Airmen provide the insurance policy the Air Force and the Nation need: a surge capability in times of national crises. In fact, the Air Force Reserve is currently mobilizing our strategic

3 Airmen of the Selected Reserve are mission-ready, capable of performing ongoing operations. Collectively, they have met the operational needs of the Air Force for decades—largely through volunteerism, but also through full-time mobilization. Between 1991 and 2003, Reservists supported the no-fly areas of Operations Northern and Southern Watch. Since the attacks on Sep- tember 11, 2001, 54,000 Reservists have been mobilized to participate in Operations Enduring Freedom, Noble Eagle, and Operation Iraqi Freedom—6,000 remain on active duty status today. It is a fact that the Air Force now, more than any other time, relies on members of the Reserve and Guard to meet its operational requirements around the globe. The Air Force Reserve maintains 60 percent of the Air Force’s total Aeromedical Evacuation (AE) capability. Reserve AE crews and operations teams provide a critical lifeline home for our injured warfighters. Our highly trained AE personnel fill 43 percent of each AEF rotation and augment existing USEUCOM and USPACOM AE forces in conducting 12 Tanker Airlift Control Center tasked AE channel missions each quarter—all on a volunteer basis. In 2009, the men and women of our Combat Search and Rescue (CSAR) forces have been heavily engaged in life saving operations at home and abroad. Since February, Airmen of the 920th Rescue Wing at Patrick Air Force Base, Florida, and their sister units in Arizona and Oregon, flew over 500 hours and saved more than 200 U.S. troops on HH–60 helicopter missions in support of U.S. Army medical evacuation operations in Iraq and Afghanistan. While mobilized for 14 months in support of combat missions abroad, the 920th continued to provide humanitarian relief in response to natural disasters at home, as well as provide search and rescue support for NASA shuttle and rocket launches. In addition, the 39th Rescue Squadron (HC–130s), also at Patrick AFB, flew rescue missions in Africa and provided airborne CSAR support during the rescue of the Maersk Alabama’s Captain from Somalian pirates. The Air Force Reserve provides 100 percent of the airborne weather reconnaissance (hurricane hunting) capability for the Department of Defense. Throughout the year, the Citizen Airmen of the Air Force Reserve’s 53rd Weather Reconnaissance Squadron ‘‘Hurricane Hunters’’, a component of the 403rd Wing located at Keesler Air Force Base in Biloxi, Mississippi fly over 1,500 operational storm hours. The Hurricane Hunters have 10 WC–130J Super Hercules aircraft that are equipped with palletized meteorological data-gathering instruments. They fly surveillance missions of tropical storms and hurricanes in the Atlantic Ocean, the Caribbean Sea, the Gulf of Mexico and the central Pacific Ocean for the National Hurricane Center in Miami. The unit also flies winter storm missions off both coasts of the United States and is also used to perform advanced weather research missions for the DOD and the National Oceanic and Atmospheric Administration (NOAA). The life-saving data collected makes possible advance warning of hurricanes and increases the accuracy of hurricane predictions warnings by as much as 30 percent. In addition to our hurricane mission, the Air Force Reserve provides 100 percent of the aerial spray mission in support of the Federal Emergency Management Agency, the Centers for Dis- ease Control, and state public health officials. Air Force Reserve aircrews and C–130s from the 910th Airlift Wing, Youngstown Air Reserve Station, Ohio, sprayed more than a million storm ravaged acres of land with pesticides to control the spread of disease. Our intelligence, surveillance and reconnaissance professionals are providing critical information as they answer the nation’s call to service. Since September 11, 2001, 1,079 intelligence personnel have deployed in support of world-wide contingency missions to include Afghanistan and Iraq. For the foreseeable future, Reserve intelligence professionals will continue to be deployed throughout the Combatant Command theaters, engaged in operations ranging from intelligence support to fighter, airlift, and tanker missions to ISR operations in Combined Air Oper- ations Centers and Combined/Joint Task Forces as well as support to the National Command Authority, such as, Defense Intelligence Agency, National Security Agency and National Geospatial-Intelligence Agency. These are but a few examples of the dedication and contributions our Air Force Reserve Air- men have made and will continue to make around the clock, around the world, each and every day. 321 airlift resources and expeditionary support to assist surge requirements in Afghani- stan.4 The Air Force Reserve is a repository of experience and expertise for the Air Force. Air Force Reserve Airmen are among the most experienced Airmen in the Air Force. Air Force Reserve officers average roughly 15 years of experience, and enlisted members average 14 years of experience, compared to 11 years and 9 years for Regular Air Force officers and enlisted, respectively. In fact, roughly 64 percent of Air Force Reserve Airmen have prior military experience. Reserve Airmen are a cost-effective force provider, comprising nearly 14 percent of the total Air Force authorized end-strength at only 5.3 percent of the military personnel budget. Put differently, Air Force Reserve Airmen cost per capita is 27.7 percent of that of Regular Air Force Airmen, or roughly 3.5 Reserve Airmen to one Regular Airman.5 However, we cannot take for granted the high level of commitment our Reservists have thus far demonstrated. We must do our best to ensure their continued service. Accordingly, we are undertaking enterprise-wide actions to make Air Force Reserve service more predictable. In the Air Force Reserve, we are revising our management structures and practices to eliminate redundancies associated with mobilizing and deploying Reservists to meet Combatant Commanders’ requirements. The intent is to create an integrated process that will be more responsive to the needs of Reservists, provide them greater predictability, make participation levels more certain, and ultimately provide Combatant Commanders with a more sustainable operational capability. This is still a work in progress. At the Pentagon, the Air Force Reserve is examining its processes to improve Re- serve interaction among the Air Force Headquarters staff to better support the Chief of Air Force Reserve, the Chief of Staff of the Air Force, and the Secretary of the Air Force in discharging their service responsibilities. Through the Air Re- serve Personnel Center, the Air Force Reserve is also taking action to improve Re- serve and Air National Guard personnel administrative and management capabilities. Collectively, these actions will contribute to the overall health of the strategic reserve and improve the sustainability of the Air Force Reserve and the Air Force operational capability required by the warfighters in this new century.

PRESERVE THE CARE AND VIABILITY OF THE RESERVE TRIAD Reservists have relationships with three basic entities: family, civilian employer, and military employer—what I like to call ‘‘The Reserve Triad.’’ Helping our Airmen preserve these relationships is critical to our sustainability. In this Year of the Air Force Family, our policies and our actions must support the viability of these relationships—especially the one Reservists have with their families. Open communication about expectations, requirements, and opportunities will provide needed predictability and balance among all three commitments. To that end, we are now consistently and actively surveying Reserve and Regular Airmen to better understand why they come to serve and why they stay. We are continually learning and gaining a better understanding of attitudes toward service and issues associated with employers and family. From their feedback, I can better advocate for benefits that help us recruit and retain Airmen for the Air Force Re- serve. Military services must be flexible: capable of surging, refocusing, and continuously engaging without exhausting resources and people. That is sustainability. Approach- ing fiscal year 2011 and beyond, it is imperative that we preserve the health of our strategic Reserve and improve our ability to sustain our operational capability.

4 Our Reserve community continues to answer our nation’s call to duty with large numbers of volunteer Reservists providing essential support to Combatant Commanders. 46 percent of the Air Force’s strategic airlift mission and 23 percent of its tanker mission capability are provided by Reserve Airmen. We currently have over 450 C–17, C–5, KC–135, and KC–10 personnel on active duty orders supporting the air refueling and airlift requirements. 5 Fiscal year 2008 budget, figures derived from ABIDES (Automated Budget Interactive Data Environment System), the budget system currently in use by the Air Force and recognized as the official Air Force position with respect to the Planning, Programming and Budget Execution (PPBE) system. Inflation data used for any constant dollar calculations were based on average Consumer Price Index for All Urban Consumers (CPI–U) rates for the past 10 years: roughly 2.6 percent average annual rate of inflation. Medicare Eligible Retirement Health Care (MERHC) is an accrual account used to pay for health care of Medicare-eligible retirees (age 65 and beyond). Cost per capita figures were derived dividing cost of Selected Reserve program by Selected Reserve end-strength. When MERHC figures are included, the cost of Air Force Re- serve Airmen to Regular Air Force Airmen increases to 30.4 percent. 322

Going forward, we need to continuously balance capabilities and capacity against both near-term and long-term requirements. Clearly, in a time of constricted budgets and higher costs, in-depth analysis is required to effectively prioritize our needs. We must understand the role we play in supporting the warfighter and concentrate our limited resources in areas that will give us the most return on our investment. Optimizing the capability we present to the warfighter is a top priority, but we must simultaneously support our Airmen, giving them the opportunity to have a predictable service schedule and not serve more than they can sustain.

BROADEN TOTAL FORCE INITIATIVE OPPORTUNITIES As weapons systems become increasingly expensive and more capable, their numbers necessarily go down. Aging platforms are being retired and not replaced on a one-for-one basis. The Air Force is required to make the most of its smaller inventory. To this end, the Air Force Reserve, Air National Guard, and Regular Air Force are integrating across the force, exploring associations wherever practical. The Air Force is aggressively examining all Air Force core functions for integration opportunities.6 Over the past 40 years, we have established a wide variety of associate units throughout the Air Force, combining the assets and manpower of all three components to establish units that capitalize on the strengths each component brings to the mix. We recently partnered with Air Mobility Command to create three more active associate flying squadrons in 2010 and beyond. About 500 Regular Airmen will associate with Air Force Reserve flying units at Keesler AFB, Mississippi (C– 130J); March Air Reserve Base, California (KC–135); and Peterson AFB, Colorado (C–130H) by 2012.7

6 The Air Force uses three types of associations to leverage the combined resources and experience levels of all three components: ‘‘Classic Association,’’ ‘‘Active Association,’’ and ‘‘Air Reserve Component Association.’’ Under the ‘‘Classic’’ model, so-called because it is the first to be used, a Regular Air Force unit is the host unit and retains primary responsibility for the weapon system, and a Reserve or Guard unit is the tenant. This model has flourished in the Military Airlift and Air Mobility Commands for over 40 years. We are now beginning to use it in the Combat Air Forces (CAF): our first fighter aircraft ‘‘Classic’’ association at Hill Air Force Base, Utah, attained Initial Oper- ational Capability in June of 2008. This association combined the Regular Air Force’s 388th Fighter Wing, the Air Force’s largest F–16 fleet, with the Air Force Reserve’s 419th Fighter Wing, becoming the benchmark and lens through which the Air Force will look at every new mission. The 477th Fighter Group, an F–22 unit in Elmendorf, Alaska, continues to mature as the first AFR F–22A associate unit. This unit also achieved Initial Operating Capability in 2008 and will eventually grow into a two-squadron association with the Regular Air Force. The Air Force Reserve Command is establishing its first Intelligence, Surveillance and Recon- naissance Group Association at Langley AFB, Virginia, this year. This Group and assigned In- telligence Squadrons of Reserve Airmen will partner with the Regular Air Force to provide operational command and control of units delivering real-time, tailored intelligence to combat forces engaged in missions in Iraq and Afghanistan, with data derived from theater Predator/Reapers, Global Hawks and U–2s, in partnership with the Total Force team. The Air Force has also programmed additional associate intelligence squadrons for Beale and Langley Air Force Bases for distributed support to global ISR operations to include USEUCOM, and USPACOM theaters. Once these units have reached full operational capability, Air Force Reserve exploitation and analysis surge capacity of Remove Piloted Aircraft (RPAs) will be approximately 10 percent of the Air Force’s capability based on 65 orbits. Additional Command and Control Intelligence, Sur- veillance, and Reconnaissance capability is being stood up with an AFRC associate Air Forces Forces Command (AFFOR) unit at Beale AFB, California, to support USPACOM and one at Hurlburt AFB, Florida to support USSOCOM global Special Operations Forces. These new capabilities create a strategic reserve force ready to respond to the call of our nation, capable of being leveraged as operational crews ready and willing to support the Regular Air Force in everyday missions around the world. This model has proven itself and is the basis for the growth of associations over the last 5 years. 7 Under the ‘‘Active’’ model, the Air Force Reserve or Guard unit is host and has primary responsibility for the weapon system while the Regular Air Force provides additional aircrews to the unit. The 932nd Airlift Wing is the first ever Operational Support Airlift Wing in the Air Force Reserve with 3 C–9Cs and 3 C–40s. Additionally, the Air Force Reserve will take delivery of an additional C–40 in fiscal year 2011, appropriated in the fiscal year 2009 Consolidated Se- curity, Disaster Assistance and Continuing Appropriations Act. This additional C–40 will help to replace the 3 C–9Cs, which are costly to maintain and fly. To better utilize the current fleet of C–40s at the 932nd, the Air Force created an Active Association. We also are benefitting from our first C–130 Active Association with the 440th AW at Pope AFB. Under the ‘‘Air Reserve Component (ARC)’’ model, now resident at Niagara Falls Air Reserve Station (ARS) in New York, the Air Force Reserve has primary responsibility for the equipment while the Guard shares in the operation of the equipment and works side by side with the Re- serve to maintain the equipment. The Air National Guard has transitioned from the KC–135 air refueling tanker to the C–130, associating with the 914th Reserve Airlift Wing. The 914th 323

But associations are not simply about sharing equipment. The goal is to enhance combat capability and increase force-wide efficiency by leveraging the resources and strengths of the Regular Air Force, Air National Guard, and Air Force Reserve while respecting unique component cultures in the process. To better accommodate the Air Force-wide integration effort, the Air Force Reserve has been examining its four decades of association experience. With Regular Air Force and Air National Guard assessment teams, we have developed analytical tools to determine the optimal mix of Reserve, Guard, and Regular forces in any given mission. These tools will give the Air Force a solid business case for associating as we go forward.

AIR FORCE RESERVE MANPOWER The Air Force is balancing Reserve forces across the full spectrum of conflict. We are leveraging the experience of Reservists to alleviate stressed career fields. And we are improving our ability to retain experienced Airmen by providing them a means to stay in the service following any life-changing decisions they make regarding full-time participation. Over the next decade, the Air Force Reserve will grow into many new mission areas, including nuclear enterprise, intelligence, surveillance, reconnaissance, unmanned aerial systems, space, and cyberspace. However, rebalancing a force can take time, and the fight is now. To meet the more pressing needs of the Air Force, such as easing strain on stressed career fields and taking on new mission sets, the Air Force Reserve is growing by 2,100 Airmen in fiscal year 2010. This will bring Air Force Reserve authorized end-strength to 69,500. By fiscal year 2013, Air Force Reserve end-strength is planned to grow to 72,100. As mentioned earlier, the Air Force Reserve is truly a cost-effective operational force; making up nearly 14 percent of total Air Force end strength at a cost of just over 5 percent of the Military Personnel budget. These manpower increases are placing a premium on recruiting highly qualified and motivated Airmen and providing them the necessary training. The Air Force Reserve recruiting goal for fiscal year 2010 is 10,500. While we met our goal of 8,800 new Airmen for fiscal year 2009 in August, nearly 2 months before the end of the fiscal year, our forecast models indicate we will continue to face challenges in both recruiting and retention. Each of these measures—Total Force Integration (TFI), expanding into new mission areas, rebalancing of forces, and, where needed, increasing manpower—will help the Air Force more closely align force structure to current and future DOD requirements, as well as provide increased capability to the combatant commanders.

AIR FORCE RESERVE MODERNIZATION The Air Force Reserve is an organization of extraordinary working people, wedded to the fabric of our great Nation. Our Citizen Airmen support all Air Force mission areas in air, space, and cyberspace. They are trained to the same standards and readiness as their Regular Component peers and are among the most highly-experienced members of the United States Air Force. A number of trends continue to influence dependence on Air Force Reserve forces to meet the strategic and operational demands of our nation’s defense: sustaining operations on five continents plus surge efforts in Iraq and Afghanistan and the resulting wear and tear on our aging equipment; increasing competition for defense budget resources; and increasing integration of the three Air Force components. The Air Force leverages the value of its Reserve Components through association constructs in which units of the three components share equipment and facilities around a common mission. Increasing integration of all three Air Force components requires a holistic approach be taken when modernizing. To ensure our integrated units achieve maximum capability, the precision attack and defensive equipment the Air Force Reserve employs must be interoperable not only with the Guard and Regular Component, but the Joint force as well. As Chief of the Air Force Reserve, I am dedicated to ensuring that Air Force Re- servists have the training and equipment available to them required to provide for our Nation’s defense. I appreciate the attention and resources provided to the Re- serve thus far, and I ask for your continued support. added four additional C–130s, resulting in 12 C–130s at Niagara ARS. This ARC Association model provides a strategic and operational force for the Regular Air Force while capitalizing on the strengths of the Air National Guard and Air Force Reserve. Additionally, in this case it provides the State of New York with the needed capability to respond to state emergencies. The Air Force Reserve has 9 host units and is the tenant at 53 locations. There are currently more than 100 integration initiatives being undertaken by the Air Force and Air Reserve Com- ponents. 324

The National Guard Reserve Equipment Account (NGREA) appropriation has resulted in an increase in readiness and combat capability for both the Reserve and the Guard. For fiscal year 2010, the Air Force Reserve Command received $55 million in NGREA appropriations. This resulted in the ability to purchase critical warfighting requirements for Reserve-owned equipment including critical upgrades to targeting pods, aircraft defense systems for C–5s and C–130s, and personnel protective equipment like security forces tactical weapons. These new capabilities are directly tied to better air support for our Soldiers and Marines in Iraq and Afghani- stan. NGREA funding has helped the Air Force Reserve to remain relevant in today’s fight as well as the ability to remain ready and capable in future conflicts. We truly appreciate and thank you for your support with this critical program.

MILITARY CONSTRUCTION (MILCON) AND INFRASTRUCTURE MODERNIZATION Along with challenges in modernizing our equipment, we face challenges modernizing our infrastructure. During the fiscal year 2011 budget formulation, both the Regular Air Force and the Air Force Reserve took risk in military construction appropriation in order to fund higher priorities. Over time, this assumption of additional risk has resulted in a continuing backlog exceeding $1 billion for the Air Force Reserve. I would be remiss if I didn’t take this opportunity to sincerely thank you for the $112 million that we received in last fiscal year’s military construction appropriation. This allowed us to address some of the most dire needs that exist in our backlog. We will continue to work within the fiscal constraints and mitigate risk where possible to ensure our facilities are modernized to provide a safe and adequate working environment for all of our Airmen.

CONCLUSION Mr. Chairman and members of this Committee, I am excited to have these roles as Chief of the Air Force Reserve and Commander of the Air Force Reserve Com- mand. I take pride in the fact that when our Nation calls on the Air Force Reserve, we are trained and ready to go to the fight. As a strategic reserve, over 68,500 strong, we are a mission-ready reserve force serving operationally throughout the world every day with little or no notice. As we approach fiscal year 2011 and beyond, it is clear the Air Force Reserve will play an increasingly vital role in meeting national security needs. The actions we initiated in 2009 and those we advance in 2010 will preserve the health of the Air Force Reserve but also help Congress address the more pressing issues we will face as a Nation in the years to come. I sincerely appreciate the support of this Committee for the appropriation and legislation it provides to our readiness and combat capability. I desire to continue working with each of you on the challenges facing the Air Force Reserve, the Air Force, and Our Nation. Thank you.

RECRUITING AND RETENTION Chairman INOUYE. I thank you very much. The subcommittee is very pleased, looking over the record of recruiting and retention. A few years ago, it was pretty bad. Now all of you have improved it. Retention is good. For example, in the Air Force, you have 20 percent retention along the first-termers. And the Marines, 20 percent of your forces are now on deployment, and yet, they’re coming in. What’s your secret? General STULTZ. Sir, I’ll lead off. As I mentioned earlier, today I command almost 208,000 soldiers. I’m authorized 205,000. That means I’ve got 3,000 more than I actually need in my ranks at this point. And the reason I have that is because of what you just said, the success of our recruiting and the success of our retention. And as people wondered about, ‘‘Are we asking too much of our Reserve components?’’ this operational tempo that we’re under, with multiple deployments of many of our soldiers, I remind them that everyone that’s in my ranks either enlisted or reenlisted since 9/11. They knew what they were getting into. They know what they’re staying for. 325 And I think, sir, that the soldiers and sailors and airmen and marines that we have joining our forces today are joining because, one, they feel a duty to their country; number two, they’re seeking to make something of themselves that they’re proud of; and three, they just feel good about what they’re doing. And if we just provide them the support for them and their families, we provide them the support for their employers, as we’ve discussed before, so that they know they have a job to come back home to, and then we give ’em predictability, they’ll stick with us. Chairman INOUYE. Admiral. Admiral DEBBINK. Chairman Inouye, I would definitely echo everything that General Stultz has said, and I would just offer some numbers for perspective. In our officer ranks, our attrition has dropped from approximately 18 percent to less than 12 percent; in our enlisted ranks, from the mid-20s down to the mid-teens. And I do believe that the primary cause for all of this is the real and meaningful work that we’re giving our sailors on a daily basis. And to the extent that we can continue doing that, which is not a problem in today’s very operational tempo, but as we look past the overseas contingency operations into the future, and working hard to identify what we call the ‘‘periodic and predictable part-time work of the Navy’’ so we give these sailors continued access to real and meaningful work, I would predict that we’ll continue to see this strong retention. Chairman INOUYE. General Kelly. General KELLY. Sir, if I could just add, I think it’s the product we offer, and the product we offer, regardless of what uniform they wear, is service to the Nation. There was a time when there were vastly larger numbers of young men and women that were willing to step forward. We don’t have as many anymore, but we have just enough out there that come in with a smile on their face and want to serve. As long as, I think—and I’m new at this business—but, it seems to me, as long as we strike the right balance between deployments, family, benefits, predictability, and the Nation keeps faith—which, to date, certainly the Nation has kept faith with all of these warriors—as long as the Nation continues to keep faith with us, I don’t think we’ll have much in the way of problems. Chairman INOUYE. General Stenner. General STENNER. Mr. Chairman, I’ll just take off from that very last statement. If the Nation continues to keep faith, we will continue to be able to provide the capabilities in each of our services. I have statistics that show that we’ve asked the questions, ‘‘Why do you join?’’ and then, ‘‘Why do you stay?’’ The number one answer on every single one of those is: patriotism. They want to serve their Nation, as has been said up here. I will add to what has been said—and I agree with everything that my partners have articulated—is that I think that we have kept faith, as a Nation, with some of the work that has been done to ensure we had parity of benefits. And a lot of that work over the last several years to ensure that the healthcare systems for folks who are fighting side by side, are equal and right and just. The GI bill, sir, has been an absolute huge retention-and-recruiting tool, especially when you can pass those benefits to families. 326 Everything that has been done to make sure that all three components—Active, Guard, Reserve—have this kind of equality and fight side by side, doing the meaningful work that has been mentioned, they want to go. The benefits are equal. The patriotism piece is felt. The Nation keeps faith. And our folks are amazing people and will continue to serve. Chairman INOUYE. All of you have problems with equipment shortfalls. But, with the Army, I note that it’s about $6 billion. And why is the Army always underfunding the Reserves? Is there a reason for that? General STULTZ. Senator, I don’t think it’s because they don’t like us. I think we face the challenge of transformation, modularity, and a changing enemy. And just as was given testimony by the previous panel about the amount of equipment that has been flowing in our force, you can look at it from a variety of numbers. You can look at it today and say, ‘‘The Army Reserve is somewhere between 75 and 80 percent equipped, the best we’ve ever been.’’ We’ve gone from somewhere in the range of about 61 to 62 percent, when I first got here, now to almost 80 percent. But, I can tell you, we’re still short $6.7 billion in equipment if we’re looking to the future of what the Army Reserve looks like by fiscal year 2016. And we’re short somewhere to the tune of about $11 billion if you look at what we’re short, in terms of the actual modernized equipment that we need by that time. And so, one would say, ‘‘Well, you’re getting shortchanged.’’ And that’s not exactly the case, because what’s happening is, we’re transforming. When I took over this position and looked at the force of the Army Reserve, I said, ‘‘We don’t have the operational force that we need for the future. We’ve got to transform.’’ And within the 205,000 end strength that we had, we went in and converted somewhere to the tune of about 25,000 spaces into new capabilities. And that is, we took down the legacy structure that we had—a lot of administrative overhead—and we stood up transportation, military police, civil affairs, medical, all that structure, which now is coming onto the books as new structure within the existing 205,000, but it also comes with a bill for new equipment that wasn’t planned in the past, because that structure wasn’t being recognized. And so, I think one of the challenges we’ve got today is, we’ve got to continue to press for the equipment. And Congress and the American people have to understand it’s not because we’re wasting the money we’re getting—and we appreciate everything we’re getting—we’re continuing to transform the Reserve into an operational force, with new capabilities, as the Army modernizes and modularizes. And so, that bill just continues to—I won’t say ‘‘grow,’’ but it continues to be out there, because we’re always trying to play catchup to the newest capabilities we need, and the equipment that goes with them. That being said, we have partnered very closely with the Army and the Army Guard to make sure that any soldier or any unit that goes into combat is best equipped, is best trained. Where we’re lagging behind is, we don’t have the right equipment back here, in 327 all instances, to train on, for those soldiers back here that are getting ready to go. And that’s our next step, and we’ve got to do a better job of getting that equipment. We’ve got equipment back here, in that 80 percent on-hand that is allowable substitute, but it’s not that piece of equipment he’s going to operate when he gets to Iraq or Afghani- stan; it’s a substitute item. What I need is to get the modernized item back here so that he’s training on the same piece of equipment he’s going to operate when he gets into theater. Chairman INOUYE. I realize that, in the bureaucratic discipline, all of you are called upon to tell us that everything is fine, that we have all the equipment we need and the budget is fine. But, I, too, served in the military at one time, and I know what shortfalls can do. So, I’m asking all of you to submit to the subcommittee what you feel are shortfalls in equipment and what you feel is necessary for you to carry out your mission and improve your performance. So, I would hope that you could respond to that. [The information follows:] As we transition into a fully modernized operational force we continue to encounter and successfully tackle many challenges, among them equipping a modernized Army Reserve (AR). The AR’s force structure is predominantly composed of Combat Support and Combat Service Support units, as such to effectively complete our mission, now and into the future we must not only ensure we fully equip our formations with the required quantities of equipment but we must also strive to equip them with the most modern and capable version available. The AR supports the Army’s fiscal year 2011 President’s budget which reflects the Army’s highest priorities. In addition to the Army’s fiscal year 2011 President’s budget, the Army submitted a list of war-related items where additional resources would enhance existing programs. The list, totaling $358.7 million, includes programs that support the AR. —Civil Affairs/Psychological Operations (CA/PsyOps) equipment for Tactical Local Area Network (TACLAN) and peripheral systems for Information operations and Irregular Warfare. 80 percent of the CA units and 84 percent of the PsyOps units reside in the AR. $55 million for TACLAN equipment will greatly enhance the AR CA/PsyOps units’ ability to perform their wartime mission. —NAVSTAR GPS: Defense Advanced GPS Receiver (DAGR). Of the $51.2 million request, $10.8 million will go toward filling 4,000 of 6,000 AR DAGR shortfall. The budget as submitted by the President will allow the Navy Reserve to carry out its mission as part of Navy’s Total Force. AIR FORCE RESERVE UNFUNDED REQUIREMENTS LIST (PROCUREMENT)

Qty Item Cost Total Cost

C–130 Large Aircraft Infra-Red Countermeasure System (LAIRCM) ...... 21 $3,000,000 $63,000,000 A–10/F–16 Helmet Mounted Integrated Targeting (HMIT) ...... 39 155,000 6,045,000 C–130 Secure Line of Sight/Beynold Line of Sight (SLOS/BLOS) ...... 63 350,000 22,050,000 C–5 Aircraft Structural Issues ...... 6 11,000,000 66,000,000 C–5 Large Aircraft Infra-Red Countermeasure System (LAIRCM) ...... 9 10,000,000 90,000,000 F–16 Center Display Unit ...... 24 208,333 5,000,000 AFRC ATP Procurement & Spiral Upgrade ...... 54 1,000,000 54,000,000 C–130 Aircraft Armor ...... 79 200,000 15,800,000 C–130 Modular Aerial Spray System (MASS) (Request is for 3600 Appropria- tion—Developmental) 1 ...... ( 2 ) ( 2 ) 20,000,000 C–130 Modular Aerial Spray System (MASS) (Follow-on Procurement Appropria- tion—Prior 3600 Funds Required) ...... 6 2,670,000 16,020,000 C–130 Crash Resistant Loadmaster Seats ...... 76 250,000 19,000,000 KC–135 Large Aircraft Infra-Red Countermeasure System (LAIRCM) Light ...... 15 1,000,000 15,000,000 C–130 NVIS Windows (Installs) ...... 64 15,625 1,000,000 C–17 Armor Refurbishment and Replacement ...... 17 117,647 2,000,000 Security Forces Weapons & Tactical Equipment ...... ( 3 ) ( 4 ) 5,500,000 Trunked Land Mobile Radio (Carswell) ...... ( 3 ) ( 4 ) 3,900,000 F–16 Simulation Training Device Upgrade ...... 2 1,100,000 2,200,000 328

AIR FORCE RESERVE UNFUNDED REQUIREMENTS LIST (PROCUREMENT)—Continued

Qty Item Cost Total Cost

F–16 Combined AIFF with Mode 5/S for RVSM & Autonomous ID capability ...... 16 380,000 6,080,000 F–16 All WX A–G Precision Self-Targeting Capability ...... 54 2,222,222 120,000,000 A–10 On Board Oxygen Generating System (OBOGS) ...... 54 204,703 11,053,962

Total ...... 543,648,962 1 One Item Developmental Appropriation. 2 Not available. 3 Various. 4 Various items.

INTEGRATION WITH ACTIVE FORCES Chairman INOUYE. Senator Cochran. Senator COCHRAN. Mr. Chairman, I want to be on the record as seconding the motion and the suggestion that you’ve just made. And looking over the notes in preparation for the hearing, that was one thing that stood out. In looking at the management responsibilities that you gentlemen have, and the responsibilities that you have of transition to becoming more and more of an Active component of our military force structure, rather than a traditional Re- serve component that’s just called upon from time to time to join the force; you’re in the force every day, in terms of training and mobilization plans, equipment, upgrades, on and on. And I can appreciate the fact that that’s a tough, tough job, particularly since most folks think they are part-timers, in the Reserves. I was a Reserve officer, and, you know, I would put on the uniform from time to time, and go on Active Duty for a short period of time. One of the most enjoyable experiences was being an instructor at Officer Candidate School in Newport, Rhode Island. I thoroughly enjoyed that. I worked a good deal with the Navy that, during—when law school wasn’t meeting, I’d get to go back on Ac- tive Duty and be an instructor, because it was building up for the Vietnam challenges and the things that were going on right then. That was a new program, they were trying to supplement their teaching complement with Reserve officers. Well, that was terrific for me. I didn’t have to go work in a law firm as a clerk or something for a summer job. But, I wonder, are we making the adjustments? Do we need to do something, like provide funding specifically dedicated for these purposes of reorganizational changes that have to be made, and resetting the force, so that you can operate seamlessly as an Active Duty force, at a moment’s notice? General KELLY. Well, sir, from the Marine Corps perspective, just talking about these reset issues and the equipment issues and all, I think we’re unique, in that our Reserve units, as they’re spread around the country, have a training allowance to work with, and that is sufficient for them to keep up with their training. And then, of course, as they get closer and closer to deploying to Af- ghanistan or Iraq, once mobilized, they get all their equipment and move to training sites and get ready to go. So, from my perspective, if the Marine Corps has got a problem, then I have the same problem. And, of course, the reset—Commandant, I think, has testified in this subcommittee, and others, that our reset and reconstitute bill, Marine Corps-wide, is something in the neighborhood of $13 329 billion. If you address that, you address my issues. But, again, I think I’m a little bit unique than the other services are, I believe. Senator COCHRAN. General. General STENNER. Senator Cochran, I will tag onto that, saying that we are probably also, as an Air Force, more closely aligned, and the equipment that we have, we share, in the association models. So, when the Air Force recapitalizes, all three components recapitalize. But, I will tell you that there’s an awful lot of changing of mission sets right now. And some of the things that are going on with intelligence, surveillance, reconnaissance, cyberspace, space missions, the things that happen when you are deployed in place, so to speak, at home station, require a good bit of infrastructure modification. And in a lot of cases, with those new missions, and the high tech that comes with them, there comes a bill. So, the old facilities don’t marry up. The infrastructure, the facilities, sustainment, restoration (FSRM) dollars that we need on a continuing basis to keep those facilities going, and, in some cases, the Milcon necessary to transition to new mission, are both as important to us, as an Air Force, as the recapitalization piece that goes into that. And the NGREA dollars we leverage to facilitate an expeditious recapitalization is also, of course, very, very important to us, as well. Senator COCHRAN. Admiral. Admiral DEBBINK. Senator, I would offer that, as our CNO has stated, we are one Navy today, with an Active component and a Reserve component. And that type of integration has driven us to the point that we work very closely with all of our procurement. Couple of examples might be, for example, anytime the Navy needs to fly logistics anywhere, it flies on Navy Reserve aircraft. Now, it just says ‘‘Navy’’ on the side, but they’re actually Navy Reserve aircraft. Anytime our special operations forces over in Afghanistan get on a helicopter at night, it’s a blended squadron of Active and Re- serve getting onto those HH–60s. And so, that’s a fully supported mission. We stood up our fourth riverine force. We’re in process of doing so right now. And that’ll be also a blended mission, Active and Reserve. I think the real key to all of these procurement accounts is what we list as our second strategic focus area, and that is to provide valued capabilities. And if we are doing that as a Reserve component, the resourcing will follow, to the extent that it can, with the overall constraints on the budget. Senator COCHRAN. General. General STULTZ. I guess I get to be the naysayer. I think the challenge we face today is, we have operationalized the Army Reserve. We are using the Army Reserve as part of the total force on a repeated basis, and we have developed a cyclical model, called our Army Force Generation Model, that says—the Army is on this same model, where—1 year forward, 2 years back home; the Reserve is 1 year forward, 4 years back home. And that means that you go through a cycle of progressive readiness, where you’re building capability so that, when you come into that available window, you’re trained, ready, and equipped. That means that each year in that cycle, you are required increased support for 330 equipment, increased support for training dollars, because there’s more expected of you to get ready. The problem is, our budget and our funding is based on the Army Reserve you came into; one weekend a month, 2 weeks in the summertime. It’s not based on this operational model. And so, everything that we’re funding today, in most cases, to put the units through that model—and we do, and we get ’em out, best trained, best qualified, ready to go—is based on overseas contingency operation dollars or supplemental dollars that we’ve gotten. What we have to do is, we’ve got to get those dollars identified and put them into the base budget of the Army and the Army Re- serve as requirements for the future, because we’re going to be in an extended period of conflict. And when we have put so much capability in our Reserve components today—the Army Reserve that I have today accounts for 60 percent of the Army’s medical capability. Over 80 percent of its civil affairs capability. At least one- third or more of the engineer, logistics, and transportation capability. And if you combine us with the National Guard, 75 percent of the engineer capability of the Army is in the Reserve components. You cannot fight an extended conflict without reliance on the Reserve as part of that operational force. Yet, we haven’t built the budget model to allow it to do that. And I think that’s the challenge, as we’re looking forward into the 2012–17 years, is that we’ve got to put that into the budget. And the Army has to figure out how to accommodate that, because we know we’re going to be in a period of, you know, limited budget increases. But, we’re going to have to—if we operationalize the Re- serve—and, in my opinion, we don’t have a choice—then we’ve got to put those dollars required for training, for equipping, all that, into the base budget. And that training has to be, not just at a training center somewhere, where you send ’em for that 2 week, 3 week, or whatever, period of training, it’s also got to be the training capability when they’re in their home station, that they’re getting meaningful training. You know, soldiers tell me today, ‘‘Don’t waste my time. You know, if you’re going to have me come to a weekend drill, make it meaningful.’’ And we’ve got soldiers now that are coming back from their second and third deployment, and the last thing they’re going to accept is for us to send ’em to a Reserve unit on a Saturday and sit ’em in a classroom. They want something meaningful. They’ve been there, they’ve done that. They want that piece of equipment that they’ve just been, in theater, operating; not coming back home and looking at that 30-year-old truck that they’re saying, ‘‘We don’t use that anymore.’’ So, that’s the challenge. Yes, sir, we’ve got to get more resourcing into our budgets for the Reserve component if we’re expected to use it as an operational force, which I think we don’t have an option; it is part of that force. Senator COCHRAN. Thank you very much. Thank you for your leadership and your service. ADDITIONAL COMMITTEE QUESTIONS Chairman INOUYE. And we thank you very much, gentlemen, for your testimony this morning. And we thank you for your service to 331 our Nation. And we thank the men and women of your command for their service to our Nation. [The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

QUESTIONS SUBMITTED TO LIEUTENANT GENERAL JACK C. STULTZ

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

TRANSITION TO OPERATIONAL RESERVE Question. General Stultz, the Army Reserve continues to transition from a strategic to an operational reserve. Do you believe the Army is adequately resourcing the Reserve to make this transition? Answer. The Army is committed to maintaining a trained and ready Reserve Component force as full participants in the ARFORGEN process. Steady state funding to achieve this goal is a topic for our fiscal year 2012 budget deliberations. The Army National Guard and the Army Reserve, like the Active Army, currently rely on Overseas Contingency Operations funding to resource readiness for the current fight including pre-mobilization training and reintegration activities. We anticipate working with the Army National Guard and the Army Reserve to come to a consensus position on this issue. Question. What are the biggest challenges still remaining? Answer. The Army and Army Reserve is currently evaluating the resource requirements to achieve an ‘‘operational reserve’’ in the fiscal year 2012–17 POM. De- cisions on fill level for full time staff, funded training days, and type of training will all drive the cost of operationalizing the reserve component. The Army has not yet validated the $1.5 billion training cost estimate and anticipates there are cost impacts beyond training that must be evaluated. Question. General Stultz, the transition to the operational reserve has increased the need for full time support personnel. The Army was supposed to conduct an analysis 2 years ago to reevaluate the Reserve’s full time support requirements but, so far, these studies have failed to produce actionable results. What is delaying this decision? Answer. Creating a sustainable operational Reserve Component requires competition for scarce resources. The Army has validated the requirements reflected in the 2005 report and the optimal solution is 100 percent manning of the validated requirement. However, given funding constraints and the past 8 years experience, the Army Reserve has proven we can provide trained and ready units, within the current required timeframes, with our current level of Full-Time manning augmented by a substantial level of Full-Time Equivalents using ADOS to build readiness in ARFORGEN and support RTC/CSTC requirements. That is why we have supported FORSCOM’s operational model as the minimum critical requirement for the 2012– 17 POM.

QUESTIONS SUBMITTED TO VICE ADMIRAL DIRK J. DEBBINK

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

CONTINUUM OF SERVICE Question. Admiral Debbink, the Navy Reserve has initiated a program called the Continuum of Service which would allow sailors to easily transition between active and reserve service. This is a novel approach to the idea of military service. What is the status of this program and has it been successful so far? Answer. Continuum of Service (CoS) is a Total Force imperative and one of my three Strategic Focus Areas for the Navy Reserve. CoS reflects the reality of our Navy—as our Chief of Naval Operations, Admiral Gary Roughhead, states, ‘‘we are one force today. One Navy, with an Active Component and a Reserve Component.’’ This is what CoS is about—bringing together our active component (AC) and reserve component (RC) to provide an integrated and balanced Force to meet current and emerging challenges in the most cost-effective way possible, while concurrently honoring all our Sailors who desire to serve our country to the best of their ability. We have been very successful with the implementation of our CoS strategy since we launched it in fiscal year 2009. As barriers to seamless movement between the AC, the RC and civilian service are removed, our ability to deliver operational flexi- 332 bility and strategic depth at the best value to the Navy increases dramatically. The CoS philosophy of recruiting Sailors once and retaining for life through variable and flexible service options is providing Sailors a career continuum of meaningful and valued work. CoS is forcing us to think differently and make major changes in the way we do business, including changes to regulations, policy and law. We now have systems and business processes in place to ease the transition between components. For example, AC Sailors can now choose to affiliate with the Selected Reserve while still on active duty, eliminating the requirement to be re-recruited into the RC upon leaving active service. At the Naval Personnel Command, a Career Transition Office (CTO) was established to support optimized assignment of personnel into available Navy active and reserve billets, decreasing transition processing times and error rates while increasing reserve Sailor transition and affiliation rates. We started with officers transitioning from AC to RC, and immediately realized positive results by nearly doubling Navy Veteran officer affiliation rates from 28 percent to 53 percent. We have recently expanded the program to include enlisted Sailors transitioning from AC to RC. In the future, the CTO will handle all officer and enlisted transitions from AC to RC and RC to AC, except mobilizations. Foremost among my list of priorities is to field a Total Force Future Pay and Per- sonnel System (FPPS). The Navy and Navy Reserve currently have separate pay and personnel systems, designed and built in an era when Sailors rarely mobilized or transitioned between components. FPPS would support the timely and seamless transition on and off active duty without the existing delays and confusion regarding pay and benefits. The development of FPPS is the Navy Reserve’s top priority for 2010.

CAREER INTERMISSION PILOT PROGRAM Question. Currently reservists have numerous opportunities to transition to active service but only a small number of active duty sailors, who are part of a pilot program, have opportunity to make a short term transition to the reserve. Do you see this pilot program expanding for active duty sailors? Answer. Our Continuum of Service (CoS) initiatives provide several ways for Sail- ors to transition back and forth between components over the course of a career. Navy Personnel Command’s Career Transition Office engages Sailors nearing the end of their active service obligation, aiding and incentivizing them toward affiliation with the Reserve Component. Navy’s Career Intermission Pilot Program, authorized by Congress in the fiscal year 2009 NDAA, is just one of the ways to transition between components. It provides a one-time temporary transition from active duty to the Individual Ready Re- serve for up to 160 service members during the timeframe from 2009–2012, to pursue personal or professional growth outside the service while providing a mechanism for their seamless return to active duty. At the end of the program participation, the member returns to active duty service with an adjusted Pay Entry Base Date, or lineal number, to reflect service time commensurate with their peers and to ensure continued promotion opportunity. Based on the Congressional authorization, similar programs are currently being developed by the U.S. Army and the U.S. Air Force for summer 2010 and the Department intends to request permanent authority for this program in the fiscal year 2013 NDAA. The limited number of active duty sailors who are participating in the pilot program to date may reflect the current economic environment, as well as other factors which we are assessing. We feel it is important to offer our Sailors multiple avenues to transition between components to accommodate individual circumstances. Though any one program may not seem to be significant, the opportunities represented by the aggregate of our CoS programs are one of the main tenets of our ‘‘Top 50 Orga- nization’’ emphasis.

NAVY AND MARINE CORPS RESERVE OFFICER RECRUITING Question. Admiral Debbink and General Kelly, over the last several years both the Navy and Marine Reserves have struggled with officer recruiting. The Marine Reserve is now back to its authorized end strength but the Navy Reserve is still facing a serious officer shortage, due to years of low recruiting. Have you shared strategies for attracting and retaining reserve officers? What measures are being considered by the Navy Reserve to address remaining shortages? Answer. Due to the different target populations for Navy Reserve and Marine Corps Reserve Officer Recruiting, General Kelly and I have not engaged in detailed strategy discussions for attracting and retaining reserve officers. However, the Chief 333 of Naval Personnel and I have a shared vision of implementing initiatives and programs to have all Reserve communities ‘‘healthy by 2014.’’ Navy Reserve Recruiting difficulties are mostly concentrated in recruiting personnel with highly sought-after skills—both in the military and in the private sector—and capturing our warfare qualified Navy veterans. High retention within the active component has limited the pool of veteran officers and has increased our reliance on Direct Commission Officers to meet annual recruiting goals. Over the last couple of years, our primary challenge has been in recruiting Reserve Medical Offi- cers, where our goal increased 43 percent in fiscal year 2010 alone. Another challenging officer community is Special Warfare/Special Operations, a community that is in high demand supporting overseas contingency operations. Our primary recruiting challenge for fiscal years 2010 and 2011 will be in the Navy Veteran (NAVET) market. As more Navy Officers opt to remain on active duty, which is truly good news for Navy, the NAVET goal is becoming increasingly difficult to achieve. Despite historical lows in RC officer attrition, increasing Reserve Component (RC) retention will help alleviate the some of the shortfalls in specific communities and pay-grades. Navy has several measures and initiatives in varying stages of implementation to improve RC officer manning including: (1) expansion of lateral transfer opportunities, (2) flexible mobilization policy for medical professionals, and (3) implementation of a RC officer retention bonus. Improving RC officer retention, increasing and expanding our DCO program, and capturing a larger percentage of the NAVET market, are all elements of our strategy to attract and retain officers to meet our goal of getting healthy by 2014. Question. Admiral Debbink, how is the shortage of officers, particularly in critical specialties, affecting the readiness of the Naval Reserve? Answer. Overall, the shortage of officers in the Navy Reserve has a limited affect on the readiness of our Force. However, we do have significant shortages of officers in two major categories: Healthcare Professionals in Critical Wartime Specialties (to include Medical Corps, Dental Corps, Nurse Corps, and Medical Service Corps); and critical undermanned non-healthcare designators (to include SEALs, Civil Engineer Corps, Supply Corps and Explosive Ordinance Disposal (EOD) officers). Each of these communities is undermanned and faces possible shortfalls in meeting dwell time targets, placing those communities under continuous stress. During fiscal years 2007–2009, high mobilization demand had a direct (though not necessarily causal) relationship to high officer attrition, particularly for junior officers. The Navy is considering options for better managing demand for critical Re- serve Component (RC) specialties, including adjusting Total Force deployment schedules to improve Reserve mobilization dwell times, and deleting or not filling some Overseas Contingency Operations requirements that would require unacceptable dwell times, resulting in additional stress on the Active Component as well as the Joint Force. Additionally, the use of incentive programs has increased Navy’s ability to assess officers and increase retention in these stressed communities, but there are still projected shortfalls in some communities for several years.

QUESTIONS SUBMITTED TO LIEUTENANT GENERAL JOHN F. KELLY

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

MARINE CORPS RESERVE—STRAIN ON THE FORCE Question. General Kelley, the Marine Corps Reserve is maintaining a high operational tempo with nearly one-fifth of the force mobilized this year. Over 20,000 Ma- rine reservists have been deployed more than once since 2001. This must put a huge strain on your reservists, their families, and employers. How is this high operational tempo affecting morale? Answer. In my travels across the numerous sites and facilities that comprise MARFORRES, I routinely encounter Marines from all walks of life and military job specialties. For the most part, they are a well seasoned force of combat veterans whose pride in their accomplishments serving this nation may be exceeded only by the level of their morale. They have a strong desire to stay in the fight, to be part of the Total Force Marine Corps even as hostilities in the current conflicts start to wane. That they still are willing to stand strong while having to balance civilian employment in addition to family concerns is a testament to their patriotism and esprit de corps. We certainly recognize the costs associated with the current operations but have mitigated them to a large degree with the use of our Force Genera- tion Model, which provides needed predictability for the Marines, their families, and their employers. 334

Question. General Kelley, the active duty Marine Corps has now completed its end strength growth. Will this reduce the operational tempo for the Marine Reserve? Answer. The Marine Corps Total Force—Reserve and Active Components—are now in balance and both are approaching the Commandant’s desired dwell time. So long as we are involved in a major overseas contingency operation this balance will be maintained. To the specific question, Yes, I expect the tempo will be reduced to the benefit of the Operational Reserve. This should stabilize our dwell time to meet or exceed the desired one to five ratio, and add to our already established unit deployment predictability for our Reserve Marines, their families, and their employers. It will allow us to continue to use the MARFORRES Force Generation Model to ensure our Reserve units are ready to answer the nations call in the face of any future contingency or requirement. We have achieved a very favorable balance with the Ac- tive Force at 202,000 and the Reserve Force at 39,600, allowing the Operational Re- serve to maintain its place as an integral and enduring part of the Total Force.

QUESTIONS SUBMITTED TO LIEUTENANT GENERAL CHARLES E. STENNER, JR.

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

AIR FORCE RESERVE—RETENTION Question. General Stenner, after several years of low retention, the Air Force Re- serve has completely turned around its retention levels, improving retention by over 20 percent for First-Term Airmen. What is driving the improved retention and what are you doing to ensure that high retention continues? Answer. The Air Force Reserve’s continued recruiting and retention success is due to a variety of factors, but one of the most concrete is the support we have received in recent years from the President and Congress. By enhancing incentives for service, they have recognized the critical contributions of Reservists and rewarded Re- servists for that service. As a highly trained, experienced, and cost effective strategic reserve force, our members serve proudly, providing operational capability on a daily basis. In return, Congress (at the urging of the Reserve Officer Association and other support organizations) has provided numerous improvements in benefits our Reservists receive. These include flexibility in terms of service requirements, competitive pay, improved retirement benefits, inactive duty training (IDT) travel pay, Post 9/11 GI Bill education benefit, affordable TRICARE for members of the Selected Reserve, targeted pay for critical career fields, and reducing the age a retired Reservist may begin receiving retirement benefits based on their service participation. To ensure our continued retention, I frequently seek feedback on the issues important to Reservists and then I act to address their concerns. One of the methods I use to solicit feedback from our Reservists is a process known as the Reserve Inter- nal Communication Assessment Group (RICAG). In fact, one incentive initiated based on information from a RICAG, the TRICARE Retired Reserve program, is expected to begin this fall. Another factor important to Reservists, their families, and employers is predictability. We continue to improve the predictability and sustainability of deployments and participation in contingency operations, making it easier for members to volunteer, mobilize, and deploy. These enhancements are important steps in maintaining the Air Force Reserve’s high retention rates which are critical to sustaining our professional Reserve force. Question. General Stenner, the Combat Air Force restructure is just starting, are you concerned about its affect on retention levels? Answer. The Combat Air Force restructuring plan enables the Air Force to move manpower authorizations to emerging and priority missions such as manned and unmanned surveillance operations and F–35 training or operational missions. With- in this realignment, the Air Force Reserve will continue to offer citizen Airmen the opportunity to serve and support all mission sets across the spectrum of air, space and cyber. In part, through normal attrition (due to separations, retirements, etc.) and with Air Force Reserve end-strength increasing to approximately 72,100 Air- men, the Air Force Reserve is putting the right Airmen in the right jobs to meet mission requirements. This realignment will not affect the overall retention for the Air Force Reserve. 335

SUBCOMMITTEE RECESS Chairman INOUYE. The Defense Appropriations Subcommittee will reconvene on Wednesday, April 14, at 10:30 a.m., at which time we will meet in closed session to receive testimony on fiscal year 2011 budget request for intelligence activities. The subcommittee stands in recess. [Whereupon, at 11:54 a.m., Wednesday, March 24, the subcommittee was recessed, to reconvene at 10:30 a.m., Wednesday, April 14.]

DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, APRIL 21, 2010

MISSILE DEFENSE AGENCY

STATEMENT OF LIEUTENANT GENERAL PATRICK J. O’REILLY, DIREC- TOR

OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. I’m pleased to welcome Lieutenant General Patrick O’Reilly, Director of the Missile Defense Agency (MDA), before the subcommittee to discuss the fiscal year 2011 budget request for missile defense. The request before us today continues the administration’s efforts to achieve three goals: sustaining homeland defense against intercontinental ballistic missiles; increasing focus on defense against regional threats; and procuring and fielding proven technologies. In fiscal year 2011, MDA’s budget requests totaled $8.4 billion, a $500 million increase over fiscal year 2010. And I’m pleased to note that the request includes increases of $300 million for ground- based missile defense (GMD), $245 million for aegis ballistic missile defense, and $160 million for theater high altitude defense over the levels approved by fiscal year 2010. These near-term programs are providing missile defense assets today, a capability that this subcommittee strongly supported for many years. However, even these near-term programs have challenges. First, the GMD program had a failed intercept test last January that is still under review. Industrial-based challenges threaten the continued production of the ground-based interceptor missiles. And there is concern over whether the program has enough test articles to ensure its reliability out to 2032. Second, because of the continued success and steadfast progress of the aegis BMD system, the administration is now demanding (337) 338 more of the program, which presents new risks and new challenges. The aegis program is involved in several simultaneous efforts, concurrently developing multiple upgrades to the standard missile, upgrading ships, conducting intercept tests, and starting the aegis ashore program to deploy land-based versions of the system in Europe. Furthermore, fiscal year 2010 is the last year of the standard missile block IA production, even though we have not yet begun to test the next block upgrade. At a time when the combatant commanders are clamoring for more aegis missiles on their deployed ships, this seems like a risky proposition. And it is of particular concern, considering the test’s schedule delays of the new missile. Finally the terminal high altitude area defense (THAAD) program has demonstrated remarkable achievements over the past few years. Accordingly, MDA is now being called on to more rapidly procure and deploy THAAD batteries to the Army and conduct more rigorous and demanding tests of the system. And so, I look forward to the hearing today on the progress of these three programs that provide the foundation for missile defense for the United States and our friends and allies around the globe. In addition, MDA has many other programs that support the current and future missile defense architecture that we will discuss today. The vice chairman is now involved in another subcommittee, so may I call upon Senator Shelby. Do you have anything? Senator SHELBY. Thank you, Mr. Chairman. Mr. Chairman, I appreciate this hearing that you’ve called. And I look forward to hearing from General O’Reilly. Chairman INOUYE. Senator Dorgan. Senator DORGAN. Mr. Chairman, I’m not able to stay for the entire hearing, but I wanted to be here and welcome the General. And I will put my statement in the record. Thank you very much. Chairman INOUYE. Your statement will be accepted for the record and the subcommittee has also received statements from Senators Cochran and Bennett which will also be included in the record. [The statements follow:]

PREPARED STATEMENT OF SENATOR BYRON L. DORGAN I would like to personally thank you, Lieutenant General O’Reilly, for appearing before this subcommittee to discuss our nation’s missile defense. The defense of our great nation against nuclear or some other type of missile attack is a very important mission, and you are key to executing that mission. I look forward to discussing this important topic with you today.

PREPARED STATEMENT OF SENATOR THAD COCHRAN Mr. Chairman, I am pleased in joining you in welcoming Lieutenant General O’Reilly to testify before our subcommittee today. Providing for the Nation’s defense is an important and basic responsibility, and a functional, capable missile defense system is a key component of our national defense strategy as adversarial nations continue to pursue the capability to launch mid and long range rockets and missiles. As Iran continues to pursue a nuclear capability, and as nuclear and missile technology continues to proliferate, we need to ensure efforts to modernize our missile 339 defense system continue to address these growing threats. I am pleased to see that this budget recommends increased funding for missile defense programs, but I know there are still many challenges in making sure we meet the needs of the warfighter and stay one step ahead of emerging threats. General O’Reilly, I look forward to hearing your testimony today to help inform the subcommittee as we consider the fiscal year 2011 funding needs for the Depart- ment of Defense.

PREPARED STATEMENT OF SENATOR ROBERT F. BENNETT Mr. Chairman, Senator Cochran, I thank you for holding this hearing to examine our nation’s missile defense programs, and appreciate the dedicated interest you direct toward this critical work. General O’Reilly, please accept my appreciation and that of my constituents for the fine work you are doing at the agency. We live at a time when there is talk of a ‘‘potential’’ or ‘‘growing’’ missile threat from another nation almost every day in the news, on the Internet, and on the tele- vision. Suffice it to say, the MDA’s mission to ‘‘deploy...an effective National Missile Defense system capable of defending the territory of the United States against limited ballistic missile attack’’ is more important now than ever. It’s no small thing—as some have described the challenge of intercepting an enemy missile, to ‘‘hit a bullet with a bullet.’’ Doing so requires developing a smart system that can identify and develop technologies worthy of taxpayer funding, and equal to meet the high charge given to the MDA. Given the ever-evolving threat environment, my interest lies in seeing that the MDA’s plans to protect our nation now and in the future are adequate for the demands of our national security, and are based in proven concepts and technologies, rather than theory alone or unrealistic expectations. In addition, I am eager to hear how the agency plans to address industrial concerns for the production of solid rocket motors. For better and worse, the Federal government (i.e. the administration), doesn’t always act as the mono- lithic whole that the outside world often perceives. Specific agencies pursue their various agendas, often without realizing how their individual decisions will affect the condition of others. Such unintended consequences could be mitigated if not largely avoided if the administration, taking into consideration procurement at NASA, DOD, and MDA, would provide a comprehensive, strategic response. While I’m fully aware of the many challenges already on your plate, I hope that you will energetically continue to find solutions to all of the agencies challenges as you work to promote the security of our nation. I look forward to our discussion and hearing your testimony. Chairman INOUYE. General, it’s your show, sir. SUMMARY STATEMENT OF LIEUTENANT GENERAL PATRICK J. O’REILLY General O’REILLY. Good morning, Chairman Inouye and other distinguished members of the subcommittee. It is an honor to testify before you today on the Missile Defense Agency’s activities to continue developing and fielding an integrated, layered ballistic missile defense system to defend the United States, its deployed forces, allies, and friends. Under the oversight and direction of the Department of Defense’s Missile Defense Executive Board, the Missile Defense Agency proposes an $8.4 billion fiscal year 2011 program that is balanced to achieve the six policy goals in the Ballistic Missile Defense Review report and the combatant commanders’ and services’ missile defense needs, as stated in the latest U.S. Strategic Command’s prioritized capabilities list. First, defense of the homeland against limited attack: We continue to upgrade the ground-based midcourse defense system to increase reliability, survivability, ability to leverage a new generation of missile defense sensors, and testing to accredit our simulations. Missile fields in Alaska are in an optimum location to intercept missiles from either northeast Asia or the Middle East. The purchase of five additional ground-based interceptors and the produc- 340 tion of components to support extensive reliability testing and missile refurbishment will sustain our production capacity until 2016 and critical component manufacturing beyond 2020. Second, defense against regional threats: By 2015, we plan to buy 436 SM–3 IA and IB interceptors, 431 THAAD interceptors, 14 AN/TPY–2 radars, 9 THAAD batteries, and have 38 ballistic missile defense-capable ships available. Our regional missile defenses are adaptable to the unique circumstances of each combatant command. For example, we determined, based on updated intelligence estimates, that our previous plan for the defense of Europe could be rapidly overwhelmed, and thus made ineffective, by the large number of Iranian medium- range ballistic missiles today. Additionally, the previous program did not cover most of southeastern Europe that is exposed to today’s ballistic missile threats, would not have been available till 2017, and would have not been adaptable to changes in future threats to Europe. Therefore, we plan to deploy a larger number of interceptors in Europe in four phases as the missile threats from the Middle East evolve. The first two phases, in 2011 and 2015, respectively, provide protection against short- and medium-range ballistic missiles. The third phase, in 2018, provides protection against intermediate ballistic missiles. And the fourth phase, in 2020, provides capability to intercept intercontinental ballistic missiles from the region in which they are launched. Third, prove the ballistic missile defense system works: We have submitted a comprehensive integrated master test plan, signed by the Director of Operational Test and Evaluation, the services’ operational test agencies, and the Commander, U.S. Strategic Com- mand, to ensure we fly our missiles before we buy them. The two greatest challenges we face in developing missile defense is acquiring cost-effective, reliable targets and improving quality control of all products. Over the past year, we’ve initiated a new target acquisition strategy to increase competition, improve quality control, reduce costs, and provide backup targets, starting in 2012. However, the precise performance of missile defense systems requires stringent manufacturing standards. Until we complete planned competitions, including the greater use of firm fixed-price contracts and defect clauses, we have to motivate some senior industry management through intensive inspections, low award fees, insuring—or issuing cure notices, stopping the funding of new contract scope, and documenting inadequate quality control, to influence future contract awards. Fourth, hedging against threat uncertainty: In accordance with warfighters’ priorities, we are focusing our future technologies to develop more accurate and faster tracking sensor platforms to enable early intercepts, enhance command and control networks to rapidly fuse sensor data to handle large raid sizes, develop a more agile SM–3 interceptor to destroy long-range missiles, to enhance discrimination of reentry vehicles from other objects, and to develop high-energy laser technologies. Fifth, develop new fiscally sustainable capabilities over the long term: The Missile Defense Agency is complying with the Weapons System Acquisition Reform Act of 2009 by establishing and man- 341 aging six baselines: cost, schedule, technical, tests, contract, and operational baselines, increasing service in COCOM participation and increasing emphasis on the competition in all phases of a program’s acquisition lifecycle. We are reviewing over $37 billion of contracts for competition over the next 2 years. Six, expand international missile defense cooperation: We are currently engaged in missile defense projects, studies, and analysis with many countries including Japan, Poland, the Czech Republic, Israel, Australia, the United Kingdom, Germany, South Korea, NATO, the United Arab Emirates, Bahrain, Saudi Arabia, and Ku- wait. Additionally, Poland and Romania have agreed to host our aegis ashore sites, and we cooperatively developed the SM–3 IIA interceptor with Japan. We also continue to support expert dialogue on cooperative efforts with the Russian Federation, whose surveillance radars would enhance our ability to monitor ballistic missile development and flight testing in southwest Asia.

THE NEW START TREATY Relative to the recently expired START Treaty, the new START Treaty actually reduces constraints on the development of missile defense programs. Unless they have new START-accountable first stages, which we do not plan to use, our targets will no longer be subject to START constraints which limited our use of air-to-surface and waterborne launches of targets which are essential for cost-effective testing of missile defense interceptors against medium- and intermediate-range ballistic targets in the Pacific area. In addition, under new START, we will no longer be limited to five space-launch facilities for target launches. Additionally, the new START Treaty does not constrain deployment of ballistic missile defense. Article V, section 3 of the treaty prohibits the conversion of intercontinental or sea-based launch ballistic missiles—launchers—to missile defense launchers and vice versa, while grandfathering five former intercontinental ballistic missile (ICBM) silos at Vandenberg Air Force Base, already converted for ground-based interceptors. MDA never had a plan to convert additional ICBM silos at Van- denberg. Moreover, we determined that if more interceptors were to be added at Vandenberg Air Force Base, it would be less expensive to build a new ground-based interceptor missile field, which is not prohibited by the treaty. Regarding submarine-launched ballistic missile launchers, some time ago, we examined the concept of launching missile defense interceptors from submarines, and found it unattractive and an extremely expensive option. As the subcommittee knows, we have a very good and significantly growing capability for sea-based missile defense on aegis-capable ships. In conclusion, MDA is teamed with the combatant commanders, services, other DOD agencies, academia, industry, and our international partners to address the challenges of managing, developing, testing, and fielding capabilities to deter the use of ballistic missiles and effectively destroy them, once launched. 342

PREPARED STATEMENT Thank you, Mr. Chairman. And I look forward to answering the subcommittee’s questions. [The statement follows:]

PREPARED STATEMENT OF LIEUTENANT GENERAL PATRICK J. O’REILLY Good morning, Chairman Inouye, Senator Cochran, other distinguished Members of the Committee. It is an honor to testify before you today on the Missile Defense Agency’s support to the Ballistic Missile Defense Review (BMDR) and our $8.4 billion fiscal year 2011 budget request to continue our mission to develop and field an integrated, layered, Ballistic Missile Defense System (BMDS) to defend the United States, its deployed forces, allies, and friends against ballistic missiles of all ranges and in all phases of flight. This budget request reflects the strategy and policy stated in the BMDR report and the prioritized missile defense needs of our Combatant Commanders and the Services as stated in the latest U.S. Strategic Command’s (USSTRATCOM) Prioritized Capabilities List (PCL). The Missile Defense Agency has been operating in accordance with the principles outlined in last year’s Weapons System Acquisition Reform Act. This includes establishment of formal baselines for the system component managers, Service participation through the USSTRATCOM-led Warfighter Involvement Process, and increased emphasis on competition at all phases of a program’s acquisition life cycle. All of these steps, I believe, will maximize the return on the taxpayer’s investment dollar. Under the oversight and direction of the Missile Defense Executive Board (MDEB), chaired by the Under Secretary of Defense for Acquisition, Technology and Logistics (AT&L), MDA proposes a fiscal year 2011 program that is balanced to achieve the six strategy and policy goals documented in the BMDR report: —Defend the homeland against a limited ballistic missile attack; —Defend U.S. forces, allies, and partners against regional threats; —Deploy new systems only after effectiveness and reliability have been determined through testing under realistic conditions; —Develop new capabilities that are fiscally sustainable over the long term; —Develop flexible capabilities that can be adapted as threats change; and —Expand international cooperation.

DEFENSE OF THE HOMELAND AGAINST LIMITED ATTACK The Ground-based Midcourse Defense (GMD) system forms the foundation of our homeland missile defense against limited ICBM attack today. We continue to upgrade GMD to increase reliability and survivability and expand the ability to leverage new BMDS sensors as well as test GMD to accredit our simulations. Since the beginning of fiscal year 2009, MDA has delivered five new GBIs, upgraded Fire Con- trol and Command Launch Equipment software, completed construction of a second GBI missile field at Fort Greely, Alaska, and delivered a new silo and an additional In-Flight Interceptor Communication System Data Terminal at Vandenberg Air Force Base, California. Additionally, we are completing the missile defense upgrades to the Upgraded Early Warning Radar (UEWR) in Thule, Greenland, and we have transferred operation of the Cobra Dane Early Warning Radar and the Beale and Fylingdales UEWRs to the Air Force. We are continuing planning and design work to upgrade the Clear, Alaska Early Warning Radar. We are requesting $1.3 billion in fiscal year 2011 for GMD to continue our GBI refurbishment and reliability sustainment programs to: help sustain the fleet to 2032 and support a service life extension decision around 2027; procure an additional 5 GBIs; complete Missile Field 2 in a 14-silo configuration to accommodate a contingency deployment of eight additional GBIs; upgrade GMD Fire Control ground system software to ensure GMD leverages BMDS increased discrimination and tracking capability as sensor, data fusion and battle management network ma- tures; and complete the installation of a second GMD command and control node at Fort Greely, Alaska. Additionally, we will continue operations and sustainment of the Sea-Based X-band radar (SBX) platform to prepare for transfer of the SBX operations to the U.S. Navy in 2012. Finally, we will continue development of technologies to enhance Standard Missile 3 (SM–3) variants to protect our homeland in the future by having the capability to intercept long-range ballistic missiles early in flight in the regions from which they were launched. To validate this concept, the Under Secretary of Defense (AT&L) requested the Defense Science Board independently assess the viability of developing capability for early intercept of ICBMs. Our GMD sustainment, refurbishment and test strategy gives us the flexibility to 343 adjust to the uncertainty in the future ICBM threat. Although, we experienced a GBI vendor production break after the last procurement of GBIs in 2006, the purchase of 5 additional GBIs, and supplying ‘‘limited life’’ GBI components for refur- bishments will sustain our production capacity until 2016 and beyond. We will conduct stockpile surveillance of GBIs by testing all limited life components as GBIs are refurbished through 2032. Data collected from future GMD flight tests, results from the aging surveillance program, and future intelligence estimates regarding the pace of ICBM growth will inform decisions on the need to procure additional GBIs.

DEFENSE AGAINST REGIONAL THREATS Our fiscal year 2011 budget request balances the war fighter’s needs to develop new capabilities and grow our missile defense capacity. An integrated deployment of Aegis BMD and Terminal High Altitude Area Defense (THAAD) forms an effective, layered, regional missile defense. The Aegis BMD is a mobile system, designed to defeat short- to intermediate-range missiles above the earth’s atmosphere, and the THAAD is a rapidly deployable system, designed to engage short- to medium- range missiles both above and within the Earth’s atmosphere. Aegis has more than twice the engagement range of THAAD. Additionally, Patriot Advanced Capability 3 can add an additional layer and point defense against Short Range Ballistic Mis- siles (SRBMs). We are developing regional missile defense elements that can be adapted to the unique circumstances of each Combatant Command region. For example, we plan to deploy missile defenses in Europe in four phases as missile threats from the Mid- dle East evolve over time. The Phase 1 capability (planned to begin deployment in 2011) will provide initial protection for southern Europe from existing short- and medium-range threats using sea-based interceptors and forward-based sensors. Phase 2 (∼2015) deploys the SM–3 IB interceptor at sea and at an Aegis Ashore/ land-based SM–3 site. In collaboration with OSD Policy, USSTRATCOM, the De- partment of State, and United States European Command (USEUCOM), we are preparing to begin negotiations with Romania to locate an Aegis Ashore/land-based SM–3 site on its territory in 2015. Phase 3 (∼2018) employs SM–3 IIA on land and at sea to protect NATO from SRBM, MRBM, and IRBM threats. Poland has agreed to host this Aegis Ashore/land-based SM–3 site. The Phase 4 architecture (∼2020 timeframe) features the higher velocity land-based SM–3 IIB, a persistent sensor network, and enhanced command and control system to intercept large raids of medium- to long-range missiles from the Middle East early in flight. Since the beginning of fiscal year 2009, MDA has delivered 27 SM–3 Block IA interceptors and upgraded 3 additional ships (for a total today of 20 Aegis BMD ships); upgraded the U.S.S. Lake Erie with the next generation BMD fire control software that increases the number of threat missiles that can be simultaneously engaged and more effectively uses data from missile defense sensors external to the ship. We have also delivered two THAAD batteries (the first unit is planned to be operationally accepted by the Army by the end of this year). We have separately deployed one U.S.-operated X-band AN/TPY–2 radar to Israel on a contingency basis. We have also installed C2BMC hardware and software upgrades at command and control nodes at U.S. Pacific Command, USSTRATCOM, U.S. Northern Com- mand and USEUCOM and began C2BMC installation in the U.S. Central Com- mand. We are requesting $1.6 billion for Aegis in fiscal year 2011. We will continue the design, qualification, and testing of the SM–3 IB interceptor; manufacture 30 SM– 3 IB test and production verification interceptors (we plan to procure a total of 436 Aegis SM–3 IA and IB interceptors by 2015), and upgrade 3 additional Aegis BMD engagement ships (two Aegis BMD 3.6.1 destroyers and one 4.0.1 destroyer) for a total of 23 BMD capable ships by the end of fiscal year 2011 and 38 BMD capable ships by 2015. We will continue development and testing of the Aegis BMD 4.0.1 and 5.0 fire control system to launch SM–3 IB and IA interceptors against threat missiles when they are beyond the range of the ship’s own radar. We also will continue the co-development of the SM–3 IIA interceptor with the Government of Japan to increase significantly the area defended by the Aegis BMD system with its 21- inch diameter rocket motors, two-color seeker, and increased kinetic warhead divert capability. We also will continue to design the first Aegis Ashore battery that will be installed for testing at the Pacific Missile Range Facility in 2012. We are requesting $1.3 billion for THAAD in fiscal year 2011. We plan to deliver the second THAAD battery (we plan to procure 6 batteries by 2015), add a second launcher platoon to each battery to double the firepower to 48 interceptors, procure 67 interceptors (we plan to procure a total of 431 interceptors by 2015), and com- 344 plete hardware and software upgrades to the communications suite to enable THAAD to use fused data from all BMDS sensors. We are requesting $455 million for sensors in fiscal year 2011. We plan to upgrade the AN/TPY–2 radar software to facilitate its use as a surveillance radar or as a THAAD battery fire-control radar, optimize the radar’s ability to leverage assistance by external sensors, and support the contingency operations of AN/TPY–2 radars deployed in Japan and Israel. We will continue to develop a Concurrent Test, Training and Operations capability to provide operational BMDS sensors (including the UEWRs, Cobra Dane and Sea-Based X-band radars) the capability to conduct training and testing while continuing to provide on-line missile defense, upgrade AN/TPY–2 and Sea-Based X-band radar discrimination and dense track management software, and conduct ground and flight testing to support accreditation of sensor models and simulations. We are requesting $343 million for Command and Control, Battle Management and Communications (C2BMC) in fiscal year 2011. We plan to provide automated planners to aid a Combatant Command’s deployment of BMD assets according to its concept of operations and conduct ballistic missile defense battles according to its tactics, techniques, and procedures. Furthermore, we will develop and deploy an upgraded version of our C2BMC hardware and software to provide new battle management functions that enable shoot-look-shoot tactics between layers of U.S. and international partners’ missile defense assets, control multiple BMDS radars, correlate and combine sensor data from multiple sensors tracking the same threat into one system track, provide real-time awareness of the battle as it develops in accordance with a Combatant Command’s concept of operations, and enable engagement coordination among BMDS elements in accordance with regional Area Air Defense Plans. Additionally, C2BMC will participate in and analyze results of ground and flight tests to support accreditation of models and simulations and support war games and exercises. MDA played a significant role in the conduct of the Ballistic Missile Defense Re- view. The agency provided technical analysis and data as required by the leaders of the review to support their effort to answer the questions posed by Congress. Pre- liminary analytical results were then presented to the departmental leaders, including the Secretary and Chairman, who then made recommendations to the President. Although MDA provided these architecture assessments, it is important to recognize the decision to deploy the recommended European PAA architecture was not based solely on detailed performance predictions. Rather, the decision to deploy an Aegis SM–3-based architecture to Europe was based on the need for a flexible defense against an evolving threat from the Middle East. First, the previously proposed Eu- ropean missile defense architecture lacked a sufficient number of interceptors to defend against the current and emerging numbers of medium-range ballistic missiles (MRBMs) being fielded by Iran. Simply put, with a notional two interceptor shot doctrine, the 10 GBI interceptors proposed for Poland would easily be overwhelmed by a raid size of 6 threat missiles launched towards European targets. Second, with the European PAA, we can deploy a missile defense capability to Europe earlier than the previous Program of Record, with GBIs in Poland and an X-Band Radar in the Czech Republic. NATO Europe is threatened by a short-range and medium- range ballistic missile threat now, so this was an important variable in the decision. Upon the completion of testing in 2011, we could begin the deployment of proven capabilities to defend against the MRBM threat. Third, by creating a re-locatable, land-based version of our most capable regional missile defense system, the Aegis Ballistic Missile Defense (BMD) system, Combatant Commanders could have the capability to adjust their missile defense architectures to address the uncertainty of future missile threats without the need to develop a new missile defense system. These systems can be deployed in any theater in a reasonably short period of time. Fourth, the increased defended areas and larger raid size capacity resulting from planned enhancements to the Aegis BMD system are expected to increase the cost- effectiveness of a European missile defense against the growing missile threat over this decade. Finally, while we currently have a limited defense system against potential Intercontinental Ballistic Missile (ICBM) threats originating in the Middle East or Northeast Asia, there is no technical reason to indicate that this system would not be further enhanced by the deployments envisioned in Phase 4 of the PAA. It is important to note that the missile defense capability needs identified in the BMDR are consistent with capability needs listed in the recently approved, independently developed, classified USSTRATCOM missile defense Prioritized Capa- bility List. 345

PROVING THE BALLISTIC MISSILE DEFENSE SYSTEM WORKS A key tenet of the BMDR is to sufficiently test the capabilities and limitations of a missile defense system before we begin procurement, or we will ‘‘fly before we buy.’’ As such, missile defense projects are subject to production decisions by USD (AT&L). Additionally, we use the Services’ standard material release and operational certification processes that also rely on developmental and operational test data prior to formally fielding initial capability. Both THAAD and AN/TPY–2 have production decisions by USD (AT&L) and Army Material Review Boards planned for this year. We are requesting $1.1 billion in fiscal year 2011 to provide targets and support to missile defense projects to test new capabilities under developmental and operational conditions, including the use of actual threat missiles, to support accrediting our models and simulations and production decisions by USD (AT&L). In collaboration with the Services’ Operational Test Agencies, USSTRATCOM, and the Director, Operational Test & Evaluation, we submitted a comprehensive Integrated Master Test Plan (IMTP) in March that describes our plan through fiscal year 2015 to conduct over 150 test events to obtain specific data necessary to accredit our models and simulations and support operational assessments. The IMTP also describes our testing to support European PAA deployment decisions. To support a Phase 1 decision in 2011, we have completed 10 Aegis BMD intercept tests of short range targets. We will conduct an Aegis BMD test against an intermediate-range ballistic missile target prior to the Phase 1 deployment. Likewise, there are system level ground tests, exercises, and simulations to test system effectiveness and interoperability. The IMTP also describes our testing of the two-stage GBI and several GMD intercept tests against long-range targets. I concur with the January 2010 DOT&E January assessment that ‘‘if MDA can execute the IMTP as planned, successful VV&A of BMDS models and simulations should result, enabling quantitative and objective rather than subjective assessments of the BMDS capability in the future.’’ I further agree with the DOT&E conclusion that ‘‘objective assessments of the BMDS capability are still a number of years in the future.’’ Our recent flight test results have been mixed. From October 2008 through today MDA achieved 5 of 7 successful hit-to-kill intercepts and a number of ‘‘firsts’’ in BMDS testing. In December 2008, the GMD system engaged an IRBM target launched from Kodiak Island, Alaska, using a GBI launched from VAFB in the most operationally realistic test to date that demonstrated our ability to fuse sensor data from five on-line sensors. Unfortunately, the target in that flight test failed to release countermeasures. In March 2009, with soldiers operating the system using tactics, techniques, and procedures developed by the U.S. Army, we conducted THAAD’s first dual salvo endo-atmospheric engagement of a threat-representative separating ballistic target. The Navy conducted an intercept using an Aegis SM–2 Block IV (terminal defense) in February 2009, and we conducted an SM–3 IA intercept in July 2009. In October 2009, we supported Japan’s intercept test of an SRBM using the Japanese destroyer JS MYOKO. Although we have had three intercepts out of three previous attempts using the GMD system, our newest variant of the kill vehicle, relying on data from the Sea- Based X-band (SBX) radar, failed to intercept a target in January 2010 during a flight test to measure GMD’s performance at its maximum operational intercept range. The GBI launched successfully from VAFB and the newly designed LV–2 long-range target successfully flew for the first time out of the Reagan Test Site in the Kwajalein Atoll 7,500 km away. It was a very valuable test because we collected extensive data on the performance of the SBX and GBI, the advanced exo-atmospheric kill vehicle (EKV), and the target. We discovered new failure modes for the SBX, the EKV flew more than twice the distance it had flown in previous tests, and we collected significant new data on the EKV’s ability to acquire, track, and dis- criminate the target. The failure investigation is expected to continue for several more months before root-cause is determined and verified. It is my intent to immediately correct any deficiency and repeat the test as soon as feasible. In contrast, the most recent attempt to conduct a THAAD test last December was of no value because of a target missile failure. The THAAD interceptor was not launched and the system was not exercised. Despite the cost of more than $40 million for that test and subsequent program delays, we gained no new information on the performance of the THAAD system. The two largest challenges to executing the U.S. missile defense program is acquiring a cost effective set of reliable targets and improving quality control. Over the past year we have initiated steps to acquire a new set of targets of all ranges, including Foreign Material Acquisitions, to verify the performance of the BMDS. Our new target acquisition strategy, initiated in fiscal year 2009, procures targets in production lots to increase competition, quality control, reduce costs, and ensures 346 the availability of backup targets starting in 2012. For the next 3 years, we must continue to rely on an intensive inspection and oversight process to motivate mission assurance. Due to the precise nature of the operation of missile defense systems, very high standards of quality control and an enduring culture of disciplined mission assurance by the industry workforce is essential. We have had many successes in improving our prime contractor and supplier quality assurance. In each case, companies have been willing to identify shortfalls, invest in new capital assets and attain experienced leadership in changing cultures to establish the enduring discipline required to consistently deliver precision missile defense products. However, not all companies have sufficiently improved. Until we complete planned competitions, including the greater use of firm fixed price contracts, we will have to motivate greater attention by senior industry management through intensive government inspections, low award fees, the issuance of cure notices, stopping the funding of new contract scope, and documenting inadequate quality control performance to influence future contract awards by DOD.

HEDGING AGAINST THREAT UNCERTAINTY Missile defense technologies must be developed to adapt and upgrade our systems to counter future changing threats. In accordance with the PCL, we are focusing our future technologies in four areas: (1) developing more accurate and faster tracking sensors on platforms to enable early fire control solutions and intercepts; (2) developing enhanced command and control networks to link and rapidly fuse sensor data to handle large raid sizes of missile threats; (3) developing a faster, more agile version of our SM–3 interceptor to destroy long-range missiles early in flight; and (4) developing discrimination techniques to rapidly resolve Reentry Vehicles from other nearby objects. Additionally, we continue to research technologies for destroy- ing boosting missiles with directed energy. We are developing more mature technologies for mid-term deployment decisions around 2015 and conducting science and technology experiments for far-term (around 2020) advanced capability deployment decisions. One of the highest priority capabilities requested by the war fighter community is a persistent and precise missile tracking capability. We are requesting $113 million in fiscal year 2011 for the Space Tracking and Surveillance System (STSS) and Near Field Infra-Red Experiment satellite operations. This space operations work will demonstrate the utility of remote missile tracking from space and reduce the risk of integrating the remote tracking data of future satellites into missile defense fire control systems. MDA launched two STSS demonstration satellites on Sep- tember 25, 2009. We continue testing and operating the two demonstration satellites, including cooperative tests with other BMDS elements, and demonstrating these satellites against targets of opportunity and scheduled tests involving targets. We are also requesting $67 million in fiscal year 2011 for a new program start, the Precision Tracking Space System (PTSS), comprised of a network of remote tracking satellites, communications, and ground stations. Key attributes of the PTSS are its limited mission, uncomplicated design, lower costs, use of mature technologies, and integration with legacy data management and control systems to provide a persistent remote missile tracking capability of the areas of the earth that are of most concern for missile defense. Lessons learned from the two STSS demonstration satellites currently on orbit will inform decisions on the development of a prototype PTSS capability by the end of 2014. After validating the prototype design in ground testing in 2014, we plan to fly the first prototypes while we have industry teams compete to produce the remaining satellite constellation for initial constellation operations by 2018. We are also requesting $112 million for fiscal year 2011 for the development and testing of a remotely piloted vehicle (RPV) based missile tracking sensor system, or Airborne Infrared (ABIR) sensor system, to track large raids of ballistic missiles early in flight. We are completing an analysis of the optimum RPV platform and sensors to integrate into an effective early missile tracking system. For fiscal year 2011, we are requesting $52 million for C2BMC enhancements to develop a net-centric, Service-oriented architecture, to rapidly fuse sensor data and provide data to distributed fire control systems to intercept enemy reentry vehicles early, optimize shoot-look-shoot opportunities, and economize the number of interceptors required to defeat a raid of threat missiles. We are pursuing enhanced C2BMC capabilities and experiments to integrate interceptor fire control systems with ABIR, STSS, and other new sensor technologies. We work closely with USSTRATCOM and the COCOMs to develop and deliver the optimum C2BMC architectures in their regions. 347

We are requesting $41 million in fiscal year 2011 to develop components that increase the speed of our SM–3 family of interceptors with advanced divert capability, faster boosters, and lighter kill vehicles. We are studying the use of a derivative SM–3 IB kill vehicle and derivatives of the first and second stages of the SM–3 IIA interceptor as part of the development of the SM–3 IIB long-range missile interceptor. We are requesting $99 million for fiscal year 2011 to conduct continued research on high energy lasers. This past year we saw the significant accomplishments of the Airborne Laser Test Bed (ALTB) as it completed preparatory tests which ultimately led to two successful and historic experimental shoot-downs of a solid rocket on Feb- ruary 3, 2010, and a boosting, liquid-fueled, Foreign Material Acquisition (FMA) target on February 11, 2010. We are preparing for another test against an FMA, at nearly twice the distance, later this spring. We will continue to investigate multiple high energy laser technologies to characterize their performance while validating the modeling and simulation of long range directed energy beam propagation and beam control. Additionally, we are currently supporting the USD (AT&L)/Director for Development, Research and Engineering (DDR&E) comprehensive review of all DOD high energy laser programs to establish a department wide program for developing and applying high energy laser capabilities. We anticipate this review will define the ALTB’s role in the future development of high energy lasers.

DEVELOP NEW, FISCALLY SUSTAINABLE CAPABILITIES OVER THE LONG TERM MDA’s preferred approach to developing new missile defense capabilities is to evolve and upgrade existing capabilities to leverage the cost-effectiveness of utilizing existing Service training, personnel and logistics infrastructures. The fiscal sustainability of missile defense systems is largely determined by the cost of operations and sustainment. Therefore, MDA executes ‘‘hybrid management’’ of projects with the designated lead Services by embedding ‘‘Service cells’’ in MDA joint project offices to make design and development decisions associated with Doctrine, Organization, Training, Leadership, Personnel and Facilities (DOTLPF) to assure MDA products efficiently align with Service processes and operational concepts. MDA has established six baselines (cost, schedule, technical, test, contract, and operational baselines) to plan and manage the execution of missile defense projects. I approve the baselines of technology programs, but jointly approve with lead Serv- ice Acquisition Executives the baselines of MDA projects in product development. These baselines not only assist in our cost-effective management of MDA projects, but also provide visibility to the MDEB and Congress on the progress of our execution. The baselines of all of our projects are established in spring and will be submitted to Congress in a Baseline Acquisition Report (BAR) in June. Finally, these baselines will form the basis for USD (AT&L) production decisions.

EXPAND INTERNATIONAL MISSILE DEFENSE COOPERATION As stated in the BMDR and Quadrennial Defense Review (QDR), a key strategic goal is to develop the missile defense capacity of our international partners. We are currently engaged in missile defense projects, studies and analysis with over twenty countries. Our largest international partnership is with Japan. We are co-developing the SM–3 IIA missile, studying future architectures, and supporting their SM–3 IA flight test program. In Europe, we are participating in the NATO Active Layer The- ater Ballistic Missile Defense (ALTBMD) command and control program and war games, continuing technology research projects with the Czech Republic, and planning for the European PAA deployments, which include the installation of Aegis Ashore sites, one each in Romania and Poland. Collaboration with Israel has grown to involve the development and deployment of the Arrow Weapon System, which is interoperable with the U.S. missile defense system. MDA has completed and the United States is now in the final negotiation of an Upper Tier Project Agreement with Israel for cooperative development of an exo-atmospheric interceptor and amending the United States-Israel Arrow Weapon System Improvement Program agreement to extend the system’s battle space and enhance its ability to defeat long- range ballistic missiles and countermeasures. MDA and Israel are also jointly developing the David’s Sling Weapon System to defend against shorter range threats, to include some ranges that the PAC–3 system cannot engage. Additionally, MDA is active in supporting the Combatant Commands through international symposiums, bi-lateral and multi-lateral dialogs, planning, and analysis with Allies and international partners to help them understand the benefits of integrated missile defense in their regions. 348

CONCLUSION Missile defense is a key part of our national security strategy described in the BMDR to counter the growing threat of ballistic missile proliferation. The New START Treaty has no constraints on current and future components of the BMDS development or deployment. Article V, Section 3 of the treaty prohibits the conversion of ICBM or SLBM launchers to missile defense launchers, and vice versa, while ‘‘grandfathering’’ the five former ICBM silos at Vandenberg AFB already converted for Ground Based Interceptors. MDA never had a plan to convert additional ICBM silos at Vandenberg and intends to hedge against increased BMDS requirements by completing construction of Missile Field 2 at Fort Greely. Moreover, we determined that if more interceptors were to be added at Vandenberg AFB, it would be less expensive to build a new GBI missile field (which is not prohibited by the treaty). Re- garding SLBM launchers, some time ago we examined the concept of launching missile defense interceptors from submarines and found it an unattractive and extremely expensive option. As the committee knows, we have a very good and significantly growing capability for sea-based missile defense on Aegis-capable ships. Relative to the recently expired START Treaty, the New START Treaty actually reduces constraints on the development of the missile defense program. Unless they have New START accountable first stages (which we do not plan to use), our targets will no longer be subject to START constraints, which limited our use of air-to-surface and waterborne launches of targets which are essential for the cost-effective testing of missile defense interceptors against MRBM and IRBM targets in the Pa- cific area. In addition, under New START, we will no longer be limited to five space launch facilities for target launches. MDA is working with the Combatant Commanders, Services, other DOD agencies, academia, industry and international partners to address the challenges and difficulties of managing, developing, testing and fielding new military capabilities to deter use of ballistic missiles and effectively destroy them once launched. Imple- menting these war fighter priorities takes time, since the production time for a missile and radar is over 2 years and establishing and training a unit to create and deploy a military capability takes an additional year. Our fiscal year 2011 budget funds the war fighters’ near-term priorities while building the foundation of a layered defense system with our partners and friends that can provide an adaptive, cost-effective strategy to counter ballistic missile proliferation in the future. Thank you, Mr. Chairman. I look forward to answering your questions. Chairman INOUYE. General, last year, the President announced a shift in plans involving Europe and missile defense, and the cornerstone of this new approach is the so-called aegis ashore program. Can you give us an update on where we are at this moment? PHASED ADAPTIVE APPROACH—AEGIS General O’REILLY. Yes, sir. We have, last year, completed an analysis of alternatives of different ways of providing the type of capability that the SM–3 missile offers. It has a range of well over 800 kilometers, and it has a defended area that is quite substantial—about twice what THAAD’s is. And THAAD is about 10 times the area of—what a Patriot unit can protect. So, we’re looking for that type of capability, and we identified that by simply taking the aegis system, the combat-proven aegis system, and moving it to the land and keeping as much of it as identical as possible, reducing developmental costs. At that point, it would give the combatant commanders and the Navy the opportunity to have the same system at sea as they have at land. They have a worldwide logistics data—or logistics base, training base, and the personnel to man these systems very quickly. So, we’re very mature in the development of the aegis ashore. It has been tested and operated in a test-type configuration at White Sands, for shorter range, for over 10 years. So, we’re in a very good position, sir, to begin the integration of it and delivering the first test unit. 349

Chairman INOUYE. So, you’re on schedule now. General O’REILLY. Yes, sir. PARTNERSHIP WITH JAPAN Chairman INOUYE. Now, one of our largest partners in defense is Japan, and you have been developing the standard missile block IIA upgrade with them. Can you update us on the status of this upgrade program and the partnership with the Japanese, overall? General O’REILLY. Sir, this program is in its fifth year of development. We have matured the components, both what the Japanese will develop and are developing and what the U.S. industry is developing. We have identified all of the steps that are necessary to have a successful integration. Our first flight test will be in 2014 and our first intercept will be in 2015. We are in full agreement with the Japanese Government and have full support in this development. Within the next year, we will begin our discussions on the production arrangement between the United States and Japan. Chairman INOUYE. So, the change in government there has not affected the progress of your partnership. General O’REILLY. No, sir. I have held several high-level reviews of this program with the Japanese Government since then, and they have indicated they are in full support and their commitments are solid. Chairman INOUYE. I have several other questions to ask, but they’re more technical in nature, so I will submit them to you, Gen- eral. May I now call upon Senator Shelby. GBI NUMBERS AND TESTING Senator SHELBY. Thank you, Mr. Chairman. General O’Reilly, I have several questions for the record. You said that you need 52 GBI interceptors—30 in Alaska and 22 to be used for testing and spares. The GMD program manager stated that 19 of the 22 GBIs will be used in testing, through 2019. That will leave us with just three GBIs to conduct reliability flight testing through 2032—long span there. That would be one test every 4 years, so to speak. What kind of analysis have you done to the number of ground-based interceptors that you really need? This seems to be kind of stretching it. General O’REILLY. Sir, the—first of all, when the program manager made that comment, he is also referring to some missiles we have already procured for flight testing. But—— Senator SHELBY. Explain what you mean. General O’REILLY. We will procure 52 between now and the end of the GBI—— Senator SHELBY. Okay. General O’REILLY [continuing]. By the current plan—30 for operational capability, 4 for operational spares that—we don’t have an exact number on those operational spares, we just use that as a hedge—and then 18 more will be used in testing. By 2019, we will have tested 20 missiles, including the ones we’ve previously tested. We will have, at that point, two missiles plus the four operational spares. So, there’s a total of six missiles to make a determination, 350 over the last 10 years of the estimated life, if we don’t extend the life. These—I will make the comment that these missiles were designed with an—a very large effort on its reliability and maintainability. And, just for example, those 30 missiles in the silos will be tested 4.3 million times over its 10-year or 20-year period. So, we believe we have a very rigorous program to test the reliability, and we’re going to remove the missiles from the silos about halfway through their life and replace their limited-life components, and test those. So, sir, we believe we’re in a position to have very good insight into how these missiles are aging. Senator SHELBY. You feel real comfortable with this and your plan? General O’REILLY. Yes, sir. And—but, we do have the procurement of five new GBIs—— Senator SHELBY. Okay. General O’REILLY [continuing]. Which will reopen the production lines, which—most of them have completed their previous production. So, we’ll have five lines open through 2016—will be qualified, in case we do find that there’s a—circumstances where we need to go back to the industrial base. AEGIS AND GMD COMPETITION Senator SHELBY. General O’Reilly, we all like competition, because out of competition, generally, comes good products. And I think that’s best for the taxpayer and the warfighter. Why would you recompete the GMD program, but attempt to sole-source, some people believe, the aegis ashore program? General O’REILLY. Sir, the decision—— Senator SHELBY. Is there a reason? General O’REILLY. Yes, sir. The decision process I have to go through is, Is there a competitive or alternate sources to produce a product whenever we’re—need to acquire a new product? In the case of GMD, we put out a market survey, and the market survey indicated that there were several companies that were willing, and we deemed viable, to actually compete for GMD. In the case of aegis ashore, the concern was the timelines we are on to deliver the first test unit and the second one—the second unit, which will be the first one in Romania—or the one in Romania. That timeline required us to have—whoever the manufacturer is—to have extensive experience with the aegis weapon system, because we want it to be identical onshore as it is at sea. However, our intent is, after that point, to compete remaining aegis ashore sites. Senator SHELBY. Okay. SM–3 COST I want to get into the SM–3 with you. The 2011 budget provides for the procurement of—as I understand it—of eight SM–3 block IBs. Now, it’s my further understanding that MDA is still working on research and development for 30 SM–3 block IBs for testing. But, according to the Future Years Defense Program (FYDP), it appears that, in 2012, MDA expects to order 66 SM–3 block IB missiles. That appears to be a pretty aggressive production increase from 2011 to 2012. Have you considered adding further funding for 351 missile production in 2011 to even out the workload and decrease the cost per missile? Because, we are interested in quality, but we’re interested in cost, too, aren’t we? General O’REILLY. Yes, sir. We have considered that. The decision for the current delivery of the SM–3 IA missiles was made in 2008, because it takes 2 years to procure—to build a missile. So, if we had additional funding now added to the budget, it would not deliver additional IAs until 2013. So, I—we do have a recognized limitation in the number of missiles we have available to us. But, my ability to deliver missiles in 2 years—by that time, as you said, sir, our plans are that we’ll have the IB in full rate. On the question of rating, though—how quick we can ramp up— the first, second, and third stage of the SM–3 IB is identical to the IA. Senator SHELBY. Okay. General O’REILLY. So, we are—what we’re talking about is the front end, the kill vehicle itself. And so, we’ve—we do believe that that is achievable, given it’s that one component of the missile which will be different. START TREATY AND IRANIAN THREAT Senator SHELBY. My last—I know my time’s running out—but, General, a lot of us are concerned with aspects of the new START Treaty and its potential to limit the U.S.’s options to deploy missile interceptors. In addition, when the Obama administration decided to terminate third-site plans in Europe, Secretary Gates said the decision was based on intelligence findings that, and I’ll quote, ‘‘The threat of potential Iranian intercontinental ballistic missile capabilities have been slow to develop.’’ A new report issued just this month now states, and I’ll quote, ‘‘With sufficient foreign assistance, Iran could probably develop and test an intercontinental ballistic missile capable of reaching the United States by 2015.’’ With this report of Iran having an ICBM capability by 2015, third-site plans canceled, and a treaty that may potentially limit our response to attacks, How do you effectively plan to counter threats like this? And I’m glad that we have Senator Feinstein and Senator Bond on this subcommittee, because they’re deep into the intelligence field on this. General O’REILLY. Yes, sir. Sir, what we recognized last year, going through the Ballistic Missile Defense Review, was the inherent uncertainty in intelligence estimates. If you go back over history, there is not a pattern that we can follow. So, our recognition was, we need, as the Secretary of Defense has determined, a hedge, in case we underestimate or overestimate the threat in, especially, the case of intercontinental ballistic missiles coming from countries that currently don’t possess them. So, that is why the—we have proposed in this budget to continue completing missile field number 2 at Alaska, so we have eight additional silos than what I testified to last year. And we have also tested the two-stage GBI, or are going to test it in June. So, we’re right on the verge of testing that missile. We have a—it’s a—it’s very close in design and—to the three-stage. So, we believe we will have the ability to have a second—or an additional shot opportunity with that missile, and addi- 352 tional silos, if needed, to replace a shot opportunity we were originally looking for in Europe. Senator SHELBY. Don’t you have to basically take the Iranian threat as real, as dangerous to this country? General O’REILLY. Yes, sir. We do. They’re—— Senator SHELBY. Thank you, Mr. Chairman. General O’REILLY [continuing]. Them and other countries. Senator SHELBY. Thank you. Chairman INOUYE. Thank you very much. Senator Dorgan. START TREATY AND LIMITS TO RESPONSE Senator DORGAN. Mr. Chairman, thank you very much. Let me just say, though, that I think—my reading of the START Treaty is one that does not impose any limitations on our response to attacks. I know some are raising those questions. I don’t believe the START Treaty does that at all. And, General, you’re welcome to respond to that, if you wish. General O’REILLY. Sir, I’ve personally not found a single case where it does limit, other than prohibitions against plans we never considered doing, like converting silos. Senator DORGAN. I just—I mean, that there—I know there’ll be some disagreement on the START Treaty, and I’ve already seen some. And my colleague just referenced some of the discussion. But I don’t believe there’s any limitation in our response to attacks. AIRBORNE LASER PROGRAM I want to make the point that we spend about $132 billion, as I understand it, on missile defense work since—I think in the last 25 years or so; $132 billion is a lot of money. I was particularly interested in the Airborne Laser Program, which I understand has now been descoped to a research and development program. Can you tell me, how much have we spent on airborne laser? Do we ever expect airborne laser will become a part of our future plans? General O’REILLY. Sir, we have spent over $5 billion on airborne laser since 2002, when it became part of the Missile Defense Agen- cy. It previously was an Air Force program. We have successfully tested the intercept of a ballistic missile, earlier this year, for the first time. We accomplished many scientific historical breakthroughs in that work. We are planning to conduct another test next month, at twice the range of the last test. We destroyed the missile quicker than we calculated we would. So, everything indicates that our basic models, which were in debate, are fairly sound, and we will continue to validate our models and our simulations. There were operational concerns about the range of this particular laser and—compared to the range of surface-to-air missiles that we know exist around the world today. However, the airborne laser has proven to be a very valuable platform for testing this technology, because of the beam control in the front end of the missile and the aircraft, the way it’s been designed to carry more than one laser. So, because of that, the coil laser, which is currently on board, that we tested, was a 19—it was in the 1990s it was designed. Since then, our national labs have produced many compelling new technologies that they are demonstrating, that the De- 353 partment is reviewing now, to also integrate onto the airborne laser for more testing over the next several years, to identify a laser that’s got the standoff distances we’re looking for. CRUISE MISSILE DEFENSE Senator DORGAN. Well, let me send you some additional questions on that. Let me ask another question that has always intrigued me. Bal- listic missile defense is important. You’re working on it. There are several different plans for deployment. And I understand all that. The question is—let’s assume that we get this up and installed, and we’re going to feel safer, in terms of response to a ballistic missile attack. A far more likely attack, in my judgment, would be for a—from a cruise missile acquired by an adversary that—we have cruise missiles that are in far greater quantity than ballistic missiles. Is there a defense system for our country against cruise missiles? And if so, what is it? General O’REILLY. Sir, the prioritized capabilities list for missile defense that the Strategic Defense Command—or, the Strategic Command—STRATCOM—has provided, in March, to me is an integrated air and missile defense capabilities—prioritized capabilities list representing all the combatant commanders and the four services. And from that, they have indicated both needs for cruise missile, air-breathing, and missile defense. My charter, my responsibility is on the missile defense side. So, the services, right now, are doing the development for the cruise missile and the air-breathing threats. Senator DORGAN. But, isn’t it the case that the ballistic missile defense activities have been far more robust than the—any activities to defend against cruise missiles? And I think it—the likelihood is 5, 10, 15, 20 years from now, it’s much more likely an adversary would find some kind of a truck, whether that vehicle be land based or sea based or air based, to acquire a cruise missile and deliver a cruise missile with terrain-following guidance at 500 feet above the ground. And meanwhile, we’ve got a big ballistic missile defense system to protect against intercontinental ballistic missiles that go up into space and come down, and somebody’s threatening our country with a nuclear warhead on a cruise missile. Isn’t it the case that we have a much more robust activity on the one than we do on the other? General O’REILLY. Sir, I’m not in a position to comment on the development of the cruise missile capability. But I will tell you that on the aegis system, for example, and when we integrate with the Army’s Patriot and lower-tier systems that do handle cruise missiles, in both those cases, we participate in ensuring that our capability that we develop for missile defense is also being used for those other mission areas. Senator DORGAN. All right. Well, I’m going to send you some additional questions, General. I’m very interested in what we’re developing and the kind of protection that it affords. All of us worry that future adversaries or present adversaries can acquire increasingly sophisticated weaponry to threaten this country; there’s no question about that. And I think there’s a wide range of threats to protect against. 354 Let me make one final point, Mr. Chairman, and that is, all of this costs a lot of money, and when any of us ever talk about the Federal budget deficit, that’s—we also have to make the point that all of this ought to be paid for, year by year, one way or another, in a budgeting process. So, this is expensive, but nonetheless, very important for the country and its protection. Chairman INOUYE. Thank you. Senator Bond. MISSILE DEFENSE STRATEGY—EUROPEAN DEFENSE Senator BOND. Thank you very much, Mr. Chairman. And welcome, General O’Reilly. Thank you for being here to discuss the $8.4 million—billion missile defense budget for fiscal year 2011. In light of the significant changes made last year to our strategy, I’m pleased to see that the President has taken a serious approach to missile defense by increasing his request by over $500 million. Our ability to protect the American homeland, American troops overseas, North Atlantic Treaty Organization (NATO) allies, international partners, is tied directly to an effective global missile defense strategy. However, the President’s announcement to alter our regional missile defense architecture in Europe to a phased adaptive approach gives me and several of my colleagues serious concerns. Breaking our previous missile defense treaties with Poland and the Czech Republic not only undermines two of our NATO allies, but puts at risk our ability to protect our friends and allies in Europe and the Middle East. In addition, Iran’s capability to target our partners, to include the continental United States, with an intercontinental ballistic missile, or ICBM, is growing, both quantitatively and qualitatively. As a result, our ability to knock down a potential ICBM from Iran, whether aimed at the United States or a friend, like Israel, I’m afraid, may be degraded. Under the original missile defense plan in Europe, the third site in Poland was intended to provide a capability to knock down an ICBM from Iran by 2013. Now, that’s subsequently slipped to 2017. General, in your testimony before the Armed Services Committee yesterday, you stated that it is reasonable to believe that Iran may have an ICBM by 2015. And Chair Feinstein and I, on the Intel- ligence Committee, are following that very closely. I won’t comment on it, but that’s what you said. I’m doing the math here, and it seems that the agreement to build, in Romania and Poland in 2015 and 2018, a new phased adaptive approach, weakens our missile defense strategy and our ability to protect our friends and allies in Europe and the Middle East. I’m equally uncertain that the new approach will provide 100-percent assurance to American families from continental—in the continental United States being vulnerable to an ICBM from Iran. We know that more shots at an ICM are better. So, with the third site in Poland gone, are you sure that that will—or, at least, for the near future—are you sure that that will not weaken our capacity to knock down an ICBM in the nearer term? 355

General O’REILLY. Sir, first of all, I do recognize the uncertainty in the intelligence estimates that have been evident over the years on when ICBM capability will be available. As you say, sir, yesterday I said I could not deny that there would be a capability in 2015 if Iran is getting outside help and if they continue to develop that capability. The concern I had with the original proposal for the defense of Europe was, number one, the timelines haven’t changed. I used to be responsible for delivering that—that it takes 51⁄2 years, from the beginning to the end of a production of a missile field, another 6 months to integrate it. And the combatant command over there asked for another year to integrate that capability. So, when we were discussing, previously, of a 2013 capability, we were assuming a start years prior to where we are now, which the requirement for the ratification of the ballistic missile defense agreements in Po- land and the Czech Republic were required before we could begin that work. So, what has happened to the delay that moved it to the 2017 timeframe was primarily driven by the ratification, which did not occur in either country. Second, the capability that we are developing—it became very evident that Iran—the concern is, number one, Will they have this capability? The other concern is, What quantity are they going to procure? And we have the capability, with 30 operational GBIs, to handle—if you use the shot doctrine of two missiles against every one threat—of up to 15 being launched. The combatant commanders reviewed that. This was done with the Joint Chiefs to make an assessment on, Is that the right number, given the threat uncertainties at this time? But, as you also say, sir, we also recognize we’re going to need, in the future, a large number of interceptors that are capable of intercepting ICBMs. And they found the most cost-effective approach would be to forward-base them on our ships and at our aegis ashore sites, so we can put larger numbers, much larger than we previously proposed. Senator BOND. I thank you, sir. RUSSIA AND THE START TREATY Next, I have concerns the administration will be compelled to slow down its phased adaptive missile approach defense in Europe if Russian threat—Russia threatens to pull out of the START agreement. In particular, as the Senate Armed Services Committee hearing brought out yesterday, the Russian Defense Minister has outlined his own interpretation of START by stating unequivocally that a linkage between increased missile defenses in Europe that impede Russia’s nuclear efforts will shape its ability to effectuate START. To what extent we—he plans to modify it, we can only imagine. But, under the new arrangement, it seems to me that Russia feels it has the ability to back out of START if they don’t like the way our missile defense architecture is growing in Europe. Given recent actions by Russia, I would change President Rea- gan’s theory for dealing with Russia to ‘‘Verify, but don’t trust.’’ And I would like to know whether you feel that this indication by Russia is a threat that will—that they will get out of the START 356 Treaty if we carry forward with some of the things that we’re doing. General O’REILLY. Sir, we believe it is in the national interest of the Russian Federation to complete this treaty agreement, and in our national interest. But, on the hand—either side could back out, and both sides have made unilateral statements that they reserve that right, but that’s recognized in the treaty. From a legal perspective that I rely on with the Department of Defense lawyers, I have no legally binding restrictions, under the new treaty, to curtail any of my developmental work in missile defenses, nor have I been given any instructions to even consider that. Senator BOND. I—the assumption that backing out of the treaty would not be in Russia’s ‘‘national security interest’’ concerns me. I don’t think we can afford to hedge our bets of what Russia, or, for that matter, Iran, China, North Korea, may or may not do. I think we deserve a robust missile defense strategy that fosters trust and security, and not shape our actions to please Russia, which is not, in my view, interested in securing our national defense. So, I would urge you to continue to pursue, aggressively, all of the means available to assure that we do have the defenses that would be necessary, in a timely fashion, to protect our critical allies, as well as our country—our continental United States. START TREATY—UNITED STATES AND RUSSIA COOPERATION And I thank you. Chairman INOUYE. Thank you very much. Senator Feinstein. Senator FEINSTEIN. Thank you very much, Mr. Chairman. And congratulations on becoming a grandfather. Chairman INOUYE. I thank you. Senator FEINSTEIN. I think that’s wonderful. General, let me just compliment you on your testimony. You were very straightforward and very direct, and I just want you to know that it’s very much appreciated. Just to follow up on Senator Bond’s comments—and he and I work closely together on the Intelligence Committee—I had the opportunity to go to Geneva in November, with Senator Kyl, and to meet with both the Russian team and our team during these negotiations and spend some time with Ambassador Antonov. Two days ago, the chairman of the foreign affairs committee of the Federa- tion Council, Mikhail Margelov, and also the vice chairman, met with me. This is the body that would ratify the treaty. It’s the upper house. The Duma is the lower house. And so, it must go to the Federation Council. I had a very positive meeting with him, and really felt that there was a new voice in Russia. Now, this, of course, is the civilian voice, not the military voice. But, a real understanding of what was trying to be achieved, in terms of building trust and confidence between our two countries and, I think, a recognition that this is a different era and that all of these nuclear weapons, and the size of them, and the numbers of them, really do present jeopardy to both countries’ in the long term. So, I was very heartened by that response. 357 I have read the treaty. I have read the preamble. I have read our reaction to it. And just so that the record is clear, let me ask this question. Does anything in the proposed treaty interfere with your plans regarding missile defense? Senator SHELBY. No, Senator. Senator FEINSTEIN. Thank you. What is your interpretation of the new treaty and related unilateral statements made by Russia and the United States, with respect to missile defense? Are they similar to what was made before the first START Treaty? General O’REILLY. It is my understanding they are. As was—has been mentioned before, that we have had similar unilateral presentations made by both countries in many of our previous treaties, such as the ABM Treaty, which we pulled out of, and we saw it wasn’t in our national interest, because it did interfere with our plans to defend ourselves from the growing proliferation of missiles, which we saw. So, no, I don’t see anything distinctively different. I do think this is an opportunity, though. As you said, Senator, I have said many times, in Moscow and other capitals around the world, with engaging with the Russians, that we do have opportunities to work with them, because the missile threat—proliferation of missiles—threatens them as it threatens us. And there are great opportunities for us to cooperate in sharing our sensor data, our future research and development, and our command and control activities and exercises, in order to build confidence, between both sides, that we’re not threatening each other, but we are building ourselves a defense against the proliferation of these missiles. START TREATY Senator FEINSTEIN. What advances in missile defense technology do you think would prompt the Russians to threaten to withdraw from the treaty? General O’REILLY. My understanding is that they thought it would undermine the strategic balance between our offensive capability and their offensive capability. EUROPEAN LAND-BASED VERSUS SEA-BASED DEFENSE Senator FEINSTEIN. Thank you. I think that’s correct. Let me switch to a—different areas. A lot has been discussed in the media about the decision to shift the focus from a European land-based defense strategy to a medium-term sea-based strategy. Now, as a result, the Navy—our Navy—will assume a significant burden in providing the necessary ships, missiles, radars, and related components to really be a credible deterrent against enemy threats and to provide the required defense against actual attacks. Have we assumed new risks in continental Europe or here in the United States by shifting the emphasis away from a ground-based system to a sea-based defense? General O’REILLY. During our review last year—and we worked extensively with the Navy—the Department of Defense made the determination that there was a need to continue a ground-based capability that had greater range than our mobile systems do, such as THAAD. And in that case, we determined the aegis ashore, 358 which is taking Navy capability and putting it into a semi-permanent location that could be moved at a later date and that is flexible against threats. But, we do have that capability. On top of that, though, the Navy also agreed to be the lead service to man and equip and train those operations on the shore. That, in fact, gives the Navy greater capability, because, while the larger pool of common missiles for them to manage between sea and at land, and also for their personnel, who today the—most of the aegis assignments are at sea, and this gives the Navy leadership the opportunity to rotate between land assignments and sea assignments. And there’s a tremendous economical benefit of having one capability work both at land and at sea. We’re also increasing our number of aegis ships that have ballistic missile defense capability. Last year’s budget was for 27 ships. This year we’re proposing 38 ships to also address that issue. LAND-BASED AEGIS Senator FEINSTEIN. Thank you. What land-based requirements remain in Europe for the implementation of the new sea-based missile system? General O’REILLY. The countries of Poland and Romania have both indicated that they would be willing to host our aegis ashore system. So, as we increase the capability for aegis at sea with newer missiles that we currently have in development, including the one with the Japanese, we will have that capability on the land, and that will provide very large protection over Europe. We believe, with the—our estimates and our technical evaluations indicate, with the latest missile for aegis, the aegis SM–3 IIB, from those two sites alone, you can protect all of NATO. Senator FEINSTEIN. So—and I am extrapolating here, and please disabuse me of the notion if it’s incorrect—you are essentially saying that this new system offers a much better umbrella of protection. General O’REILLY. For the threats to Europe, it definitely provides a much greater protection. Our concern was, we—with the previous approach was, we would never be in a position, or we would not be in a position, to defend the United States, anyway, from Europe, because of our commitments under NATO to defend the European cities if they were attacked with short-range or medium-range missiles that do exist today. We wouldn’t have those 10 missiles available to defend the United States. So, we believe that the approach we have taken assures us to have capability to defend our homeland, but also greater protection over Europe, especially in southeastern Europe today that is under the threat of ballistic missiles from the Middle East. Senator FEINSTEIN. Is it fair to interpret that answer as ‘‘yes’’? General O’REILLY. Yes. Yes, ma’am. Senator FEINSTEIN. Thank you. Thank you very much, Mr. Chairman. Chairman INOUYE. Thank you very much. ADDITIONAL COMMITTEE QUESTIONS And thank you, General O’Reilly, for your testimony. It’s been very helpful. 359 [The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

AEGIS STANDARD MISSILE ACQUISITION Question. I continue to be impressed by the success of the Aegis missile defense program. I am concerned, however, that MDA is stopping production of the SM–3 Block IA missile prematurely. The Navy and the Combatant Commands want more of these missiles deployed, but there are just not enough. This Committee provided funding to buy 6 additional Block IA missiles in fiscal year 2010, but due to the continued delay in testing of the follow-on missile, there will be a production gap that compounds the shortage of fielded missiles. I understand that you are looking at alternatives for extending production of the Block IA missile. Can you please update us on the progress of those plans? Answer. In developing the fiscal year 2011 budget request, the Missile Defense Executive Board (MDEB) balanced the need for building missile inventory with continuing capability development of the next version of the SM–3. The SM–3 Block IA production line is in the final phases of production before shifting to the Block IB. The SM–3 Block IA unique suppliers begin going out of qualification in May/ June 2010 (see figure 1 of attachment 1). First discussed in 2008, it was determined that this approach was acceptable and appropriately balanced risk. Discussion.—The first flight test of the SM–3 Block IB (‘‘FTM–16’’) is in late March 2011. If a decision were made to continue SM–3 Block IA production, there are a range of options for maintaining a production line and vendor base for the SM–3 missile, numbered 1 to 4 below. These options range from buying spare parts to procuring additional SM–3 Block IAs. As of the date of this response, unique SM–3 Block IA vendors have not had work for over 6 months and are losing qualification. Loss of supplier qualification will add $53.5 million additional cost to the numbered options below to execute if orders are planned by the end of CY 2010. —Procure only spare parts in quantities which preserve supplier qualifications, fiscal year 2010 estimated additional cost of $60–70 million for 12 SM–3 Block IA ‘‘KV kits.’’ These KV kits would be full ‘‘pulse mode’’ capable and could be used to swap out the first eight SM–3 Block IA KVs that were limited to ‘‘sustain mode’’ operation or provided to the U.S. Navy as additional spares for SM– 3 Block IA requalification. If ordered, these additional missiles would sustain the vendor base through May 2011. —Combine with fiscal year 2010 additional procurement funding ($57.6 million), procure 10–12 more SM–3 Block IA, fiscal year 1010 estimated additional cost of $60–80 million, plus $10 million of fiscal year 1010 RDT&E to re-host Cen- tral Processing Unit (CPU)2. Ordering 10–12 more missiles would sustain the vendor base through May 2011. —Procure a mix of new missiles and KV kits to refurbish missiles; fiscal year 2010 estimated additional cost of $120–150 million, plus $10 million of fiscal year 2010 RDT&E to re-host CPU2. This option is a hybrid of the first 2. It would sustain the vendor base through October 2011. —Procure 36 more SM–3 Block IA missiles to keep vendors qualified over a longer term; estimated additional cost of $345–375 million, including $15 million RDT&E fiscal year 2010 to re-host CPU2 and conduct design verification tests of other parts. This would require a modification to our existing SM–3 Block IA Justification and Authorization (J&A). This option would continue SM–3 Block IA into fiscal year 2012.

THEATER HIGH ALTITUDE AREA DEFENSE (THAAD) Question. I understand that there is a Failure Review Board investigating a faulty component on the THAAD interceptor. Due to the faulty part, THAAD production is on hold. What is the current impact to the program, and how will it affect delivery of the THAAD batteries to the Army? Answer. The THAAD program has completed the manufacturing for all THAAD fire control and launcher ground components for the first two THAAD batteries. However, THAAD production interceptor deliveries have been delayed. During November 2009, in-process test failures were experienced within an optical switch during production of ignition system components for the initial lot of THAAD tactical interceptors. A Failure Review Board (FRB) was convened to assess the 360 cause of these failures. The FRB concluded that the current switch design is sensitive to contamination introduced during the manufacturing process. The switch vendor completed implementation of production contamination reduction processes and procedures and reopened the optical switch production line on May 11, 2010. The current production schedule for the first THAAD interceptor projects a first quarter fiscal year 2011 delivery.

QUESTIONS SUBMITTED BY SENATOR BYRON L. DORGAN Question. What are the 2011 plans for the Airborne Laser research and development program? What are some of the compelling new high energy laser technologies that have been or may be demonstrated? Answer. The Airborne Laser Test Bed (ALTB) is the subject of a SECDEF-directed study by the Director of Defense Research and Engineering (DDR&E), Cost Assess- ment and Program Evaluation (CAPE), and High Energy Laser Joint Technology Of- fice (HEL JTO) to shape the future of the platform. The study is due to the DEPSECDEF in June 2010 and will describe the best use of the ALTB in flight and ground tests to characterize high-energy laser beam propagation and to further investigate emerging high energy laser technologies in their implementation environment. Two new laser technologies are the Enhanced Track Illuminator Laser (ETILL) technology for kilowatt-class laser tracking, and the Diode Pumped Alkali Laser (DPAL) technology which has the potential for scaling to megawatt-class power. ETILL is a kilowatt class replacement for ALTB’s current Track Illuminator Laser (TILL) for improved active tracking of targets at extended ranges. ETILL is 2.5 times more powerful than the TILL and has 4–5 times better beam quality, enabling an approximate 400 percent increase in tracking range. ETILL is the first cryogenically cooled diode-pumped solid state laser designed to operate in an aircraft environment. The system is currently entering laser performance testing and could be integrated onto ALTB within 1 year. DPALs are a new class of lasers that combine the benefits of solid state and gas lasers. DPALs are electrically powered like solid state lasers, but have a gas lasing medium that can be flowed for scaling to higher power while maintaining good beam quality. Unlike the Chemical Oxygen Iodine Laser (COIL) High Energy Laser (HEL) currently used on the ALTB, the gas in a DPAL would be contained in a closed cycle so that no chemicals would be consumed or required for operation. DPALs can convert electrical energy to laser energy very efficiently. DPALs have been demonstrated with output powers in the hundreds of watts and DPAL scaling to the multi-kilowatt power level in the laboratory is scheduled to be demonstrated by the end of 2010 at the Lawrence Livermore National Laboratory. Subsequent scaling to a megawatt-class DPAL in the laboratory would require several more years. Question. What is the Department of Defense’s long term strategy and financial budget for this platform? Answer. Consistent with the SECDEF’s direction, the Airborne Laser Test Bed (ALTB) will transition to a directed energy test bed to conduct high energy laser experimentation. The ALTB is the subject of a SECDEF-directed study by the Direc- tor of Defense Research and Engineering (DDR&E), Cost Assessment and Program Evaluation (CAPE), and High Energy Laser Joint Technology Office (HEL JTO) to shape the future of the platform. The study is due to the DEPSECDEF in June 2010 and will describe the best use of the ALTB in flight and ground tests to characterize high-energy laser beam propagation and to further investigate emerging high energy laser technologies in their implementation environment. This report will serve as the basis for a long-term strategy for ALTB. 361

Question. Who is the DOD lead for cruise missile defense? Summarize what is currently being done to protect our deployed forces and our homeland against the cruise missile threat. Answer. The Missile Defense Agency is chartered to develop ballistic missile defense capabilities. The Services are responsible for the development of defenses against cruise missile and air-breathing threats. DEPSECDEF on July 22, 2008 designated USSTRATCOM as the Air and Missile Defense Integrating Authority.

QUESTIONS SUBMITTED BY SENATOR DIANNE FEINSTEIN Question. In an interview with Deputy Under Secretary of the Air Force for Space Programs Gary Payton, published in Space News on April 19, 2010, Dep. Under Sec- retary Payton concluded that the President’s new direction for NASA would have a small, but manageable, impact on Navy and Air Force ballistic missiles, and only a ‘‘trivial impact’’ on DOD space launch capacity. Do you share Deputy Under Secretary Payton’s conclusions? What impacts do you believe the President’s new direction for NASA has on the Department’s space and missile programs? Answer. MDA is working closely with the Air Force, NASA and other members of the Solid Rocket Motor (SRM) Interagency Task Force (IATF) to develop a consolidated assessment of the impact of NASA’s new direction on the industrial base and develop a roadmap which is due to Congress in June 2010. Question. Which major ongoing Department of Defense programs promote continued development of solid rocket motor development? Answer. For large SRM (>40 inch diameter), there are currently no development efforts among the Services and agencies in the FYDP. However, MDA is developing a 21 inch diameter (small) solid rocket motor for the SM3 IIB second stage and possibly third stage. Question. What is the long-term plan to sustain the high-tech solid rocket motor industrial base? Answer. MDA’s long-term plan to sustain the high-tech Solid Rocket Motor (SRM) Industrial Base (IB) includes supporting the SRM IB Inter-Agency Task Force (IATF) development of a SRM sustainment plan. MDA believes that we need: —To work with industry to ‘‘right size’’ and align capacity to reality; —To ensure long-term viability of small and large SRMs (missile defense and tactical systems); —To closely monitor the already fragile critical sub-tier supplier base; and —Propose plans to retain SRM expertise and facilities for future contingencies. 362

QUESTIONS SUBMITTED BY SENATOR THAD COCHRAN

ISRAELI COOPERATIVE PROGRAM SUPPORT Question. General O’Reilly, the United States and Israeli governments have been working together to develop an upper-tier component for the Israeli missile defense program. I understand the Israelis are pursuing the enhanced version of Arrow, Arrow-3, and are required to meet knowledge points to measure their progress. Can you give us an update on Israel’s progress in relation to meeting those knowledge points? Answer. The Arrow-3 development program continues to make significant progress. Three Knowledge Points (KPs) have been successfully completed, two KPs have been executed and are under review by MDA, and three additional KPs are scheduled to be executed by the first quarter of fiscal year 2011. A Critical Design Review is currently scheduled for June 2010. MDA prepared a classified report on Arrow-3 Knowledge Points which was delivered to Congress by the Under Secretary of Defense for Acquisition, Technology and Logistics (AT&L) on April 12, 2010. The report provides detailed information on the knowledge points, schedule, and assessment of program milestones. MDA has provided a separately required Arrow-3 Knowledge Point Report to Con- gress that is currently under review within the Department. This report will provide the most current KP status information and delivery is expected by the end of June 2010.

SEA-BASED ASSETS Question. General O’Reilly, it appears that there is an insufficient inventory of Ballistic Missile Defense capable Aegis-class ships to implement the President’s Phased Adaptive Approach strategy for missile defense in Europe and the Middle East and to address concerns in other parts of the world, including North Korea. Earlier this year, Admiral Walsh, the Commander of the Pacific Fleet, indicated that the U.S. Pacific Fleet had a decline in ship inventory due to supporting missions in Iraq, Africa, and battling increased incidents of piracy. General, given this decline in ship inventory in the Pacific and other regions and the increased demand associated with the President’s new strategy, how has the Missile Defense Agency and the Navy been working to alleviate the shortfall in Bal- listic Missile Defense capable ships? Is there any consideration being given to building or modifying meaningful numbers of additional Ballistic Missile Defense capable Destroyers to address these shortfalls in a timely fashion? Answer. Yes, MDA and the U.S. Navy plan to increase the number of BMD capable ships from 21 today to 38 by the end of 2015 as stated in the Additional Require- ments for Investment in Aegis Ballistic Missile Defense Report to Congress (RTC) dated April 2010. In support of this plan, Navy has requested a transfer $15 million of fiscal year 2010 funds to the Missile Defense Agency (MDA) to accelerate the number of Aegis BMD ships. The reprogramming package was forwarded to Con- gress in April 2010. In order to further complete these accelerated BMD ship upgrades the Navy has also requested the transfer of $74 million in President’s budget 2011 from the Navy to MDA.

NATO—ACTIVE LAYERED THEATER BALLISTIC MISSILE DEFENSE Question. General O’Reilly, the Quadrennial Defense Review released earlier this year stresses a focus on building partnerships with overseas allies. I understand we are beginning to integrate different components from various NATO allies to form a tiered active ballistic missile defense system. Can you highlight the United States’ contribution and cost for this effort and does it replace what we already have established with these allies? Answer. MDA has been working with NATO for more than a decade. Over the years, the MDA and NATO have worked collaboratively on developing documentation and demonstrating interoperability. This ongoing work has gained significant momentum since NATO established the Active Layered Theatre Ballistic Missile De- fense Programme Office (ALTBMD PO) in 2005. This work is the foundation of the efforts to develop interoperable missile defense capabilities with our NATO allies. Specifics include: —Current MDA budget for this is fiscal year 2010: $2.75 million; fiscal year 2011: $3 million; fiscal year 2012: $3 million. —MDA and the ALTBMD PO jointly developed Interface Control Documents (ICDs) for real-time and non-real-time information exchange. 363

—Real-time ICDs document the exchange of situational awareness information between NATO Air Command and Control System and the U.S. C2BMC, Aegis BMD, and Patriot systems. —Non-real-time ICDs document the exchange of planning and tasking information between U.S. and NATO missile defense command and control systems. —MDA and NATO have conducted bi-lateral testing of real-time information exchange between C2BMC, Aegis BMD, and Patriot systems and a prototype of the NATO Air Command and Control System. —Non-real-time exchange of planning and tasking information has been demonstrated between the U.S. C2BMC planner and the NATO planning and tasking tool (PlaTo). —MDA and NATO ALTBMD PO are developing the necessary testing infrastructure. —International Point of Presence (IPOP) laboratory serves as the U.S. interface between NATO missile defense Integration Test Bed in The Hague, The Neth- erlands and U.S. missile defense laboratories. The United States and NATO have begun discussions for a Memorandum of Agreement regarding modifications at Ramstein, AFB, to be the operational communications interface point. Information exchange between U.S. Phased Adaptive Ar- chitecture systems (via C2BMC) and ALTBMD systems will occur between the U.S. teleport on Ramstein and the NATO General Communication System at Ramstein. The United States has built bi-lateral communications enclaves for several Host Na- tions. Expanded connectivity with Allies is anticipated to be via Ramstein. A strong foundation has been documented, built and tested for interoperability between U.S. and Allied forces. Our current efforts do not replace what we have established with our NATO allies; it leverages our past efforts with the existing and planned NATO command and control systems. Subsequent work will build upon this foundation.

SM–3 MISSILE GAP Question. General O’Reilly, I understand a major component of the Missile De- fense Phased Adaptive Approach strategy involves the use of Ballistic Missile De- fense-capable Aegis ships equipped with SM–3 missiles. I have been informed that while the Missile Defense Agency continues developing the newest and more capable version of the SM–3 missile, the Block IB, the main production line for the current version, the Block IA, is shutting down. What are the costs associated with restarting the production line for the updated SM–3 missile once the line for the old missile has been shut down, and have you or do you plan to budget for these additional costs? Answer. The overall production line for the Standard Missile-3 (SM–3) missile will not shut down. The last SM–3 Block IA is scheduled for delivery in fiscal year 2012, at which time the SM–3 production line will transition from the Block IA configuration to the Block IB configuration, completing in 2013. In the interim time period, we will cease procuring unique Block IA parts and start buying unique Block IB parts. After Calendar Year 2010, the majority of Block IA unique suppliers will be out of qualification. The SM–3 Block IB production line will require some new, different test equipment and assembling processes. There is no cost to restart the SM–3 production line as work on the line (either production or transition) never ceases. The cost associated with transitioning the SM–3 production line is $55 million over 3 years. President’s budget 2011 contains a portion of that cost.

QUESTION SUBMITTED BY SENATOR RICHARD C. SHELBY Question. General O’Reilly, at the present time, only two U.S. companies produce solid rocket motors for all of our nation’s needs, and only one company manufactures their most key ingredient: the oxidizer. These three companies support all missile defense programs, plus all strategic missiles, military, and commercial space lift capabilities, NASA human spaceflight systems, and the entire cadre of tactical missiles available to today’s war fighter. Since the early 1990s, NASA has served as the anchor tenant for this industry, providing a stable backbone to offset the often inconsistent production requirements of military and commercial programs. However, demand for products made by the solid rocket motor industry has been in steady decline for many years, and is right now experiencing a further dramatic drop with the completion of the Minuteman III Propulsion Replacement Program, the retirement of the Space Shuttle, the termination of the Kinetic Energy Inter- ceptor, and the production slowdown of Ground-based Midcourse Defense intercep- 364 tors. Now, NASA has announced the cancellation of the Constellation program. This will have a significant impact on industry’s ability to continue to safely, reliably, and affordably produce solid rocket motors to meet our nation’s needs. What plans has the Missile Defense Agency made to sustain this industry, to continue to meet current deployed and future anticipated missile defense needs? I recognize that, in response to direction from the Congress last year, that the Office of the Secretary of Defense is developing a roadmap on how to best sustain this industry. What inputs have you or your agency provided to that ongoing study? Have you had any conversations with other government agencies, such as NASA, about the need to sustain this industry, and if so, please share with us any concerns you may have expressed about the impact of NASA’s decision on your ability to meet current and future missile defense requirements? Answer. MDA’s long-term plan to sustain the high-tech Solid Rocket Motor (SRM) Industrial Base (IB) includes supporting the SRM IB Inter-Agency Task Force (IATF) development of a SRM Sustainment Plan. MDA believes that we need: —To work with industry to ‘‘right size’’ and align capacity to reality; —To ensure long-term capability to produce small and large SRMs (missile defense and tactical systems); and —To closely monitor the already fragile critical sub-tier supplier base. MDA is working closely with the OSD Solid Rocket Motor (SRM) Industrial Base (IB) Inter-Agency Task Force (IATF) on the development of an integrated roadmap that includes DOD, MDA and NASA requirements. MDA’s participation in the IATF Working Group (IWG) involves hosting the IWG meetings, participating in industry site visits and assessments and

SUBCOMMITTEE RECESS Chairman INOUYE. The subcommittee will stand in recess until Wednesday, May 12, and at that time we’ll receive testimony from the Secretary and Chief of Staff of the Air Force to discuss the Air Force’s fiscal year 2011 budget request. We’ll be in recess. [Whereupon, at 11:20 a.m., Wednesday, April 21, the subcommittee was recessed, to reconvene subject to the call of the Chair.] DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, MAY 12, 2010

U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 11:01 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) presiding. Present: Senators Inouye, Leahy, Dorgan, Murray, Cochran, Bond, Bennett, and Brownback. DEPARTMENT OF DEFENSE

DEPARTMENT OF THE AIR FORCE

OFFICE OF THE SECRETARY STATEMENT OF HON. MICHAEL B. DONLEY, SECRETARY

OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. All right. First, I would like to apologize for our lateness. We had a few votes. This morning, we welcome back the Honorable Michael Donley, Secretary of the Air Force, and General Norton Schwartz, the Air Force Chief of Staff. And we thank you for being here as the subcommittee reviews the Air Force’s budget request for fiscal year 2011. For fiscal year 2011 the Air Force is requesting $150 billion in base budget. This funding level is an increase of $15.3 billion over last year’s enacted budget, excluding funding appropriated in fiscal year 2010 supplemental. The Air Force is also requesting $20.8 billion for overseas contingency operations for fiscal year 2011, and $6.1 billion for the remainder of fiscal year 2010, primarily to fund the surge operations in Afghanistan. The 2010 Quadrennial Defense Review (QDR) emphasized the need to prevail in today’s wars, while building the capabilities to deal with future threats. The fiscal year 2011 budget request is consistent with these goals. The Air Force’s budget supports its highest priorities, which are to strengthen air, space, and cyber capabilities to help win the wars in Iraq and Afghanistan. For example, the Air Force continues to invest in intelligence, surveillance, and reconnaissance (ISR) programs. These assets, such as the MC–12 Liberty aircraft (365) 366 and Reapers and Predator unmanned aerial vehicles (UAV’s) are significantly improving the situational awareness of our forces in the area. Success in getting timely information to the warfighter directly depends on having the manpower available to pilot the vehicles and to provide actionable intelligence. The Air Force will allocate more than 3,600 employees to support the processing, exploitation, and dissemination of intelligence collected by manned and remotely piloted vehicles by the end of fiscal year 2011. The Air Force will be operating 50 continuous combat air patrols with remotely piloted vehicles in the theater. And the subcommittee is pleased with the way the Air Force has rapidly increased the intelligence, surveillance, and reconnaissance capabilities to meet high theater demands, and interested in how these assets will become part of the enduring force structure. While fully engaging in the present conflicts, the Air Force is also aggressively addressing deficiencies in the older mission, the nuclear enterprise. The Air Force implemented a number of measures to strengthen stewardship of its nuclear arsenal, including the creation of Air Force Global Strike Command in August 2009. This action was a significant step in revitalizing the commitment to high safety and compliance standards in this critical mission. The budget also portrays the Air Force preparing for the future. Funds are requested to initiate the new tanker program and begin the requirements work for the new, next-generation bomber. So, too, the Joint Strike Fighter (JSF) Program is funded consistent with the Department’s most recent cost, schedule, and performance assessments. These are all important recapitalization efforts. The budget also contains substantial investment in space and space-related systems, including both major satellite programs and small efforts, like the Operation Ally Responsive Space Program, which focuses on rapid and innovative technologies. Looking to the future, the Air Force has a number of challenges, from modernizing aircraft and other equipment to ensuring that there is adequate manning for growing missions, such as cybersecurity, ISR, and the acquisition workforce. The subcommittee is interested in understanding how the Air Force is addressing these challenges. Yesterday, the Air Force announced its force structure plans for 2011. We hope our witnesses will address the proposed changes and their impact on the force capability and readiness. So, gentlemen, we sincerely appreciate your service to our Na- tion, and recognize the dedication and services made dearly by the men and women of our Air Force. We could not be more grateful for what those who wear our Nation’s uniform do for our country each and every day. And I look forward to our testimony this morning. And your full statements will be included in the record. And at this moment, the vice chairman is still at the voting chamber, so I will call upon Senator Bond, if he has any statement to make. 367

STATEMENT OF SENATOR CHRISTOPHER S. BOND

Senator BOND. Thank you very much, Mr. Chairman. I asked him to be sure and start the timer, because I’ve got a lot to say, but I join with you in welcoming Secretary Donley and General Schwartz. We welcome you back to the subcommittee. Thank you for your service. Mr. Secretary, I especially want to thank you for attending the launch of the Senate Aerospace Caucus last week with Senator Murray. We believe the American aerospace industry has made our Na- tion the global leader in the civil aviation sector, and has helped produce the strongest military in the world. Despite its importance, not only to our military and to our economy, we all recognize the industry faces several challenges. And Senator Murray and I look forward to working with you and the rest of the Aerospace Caucus to elevate the awareness about the challenges and the efforts to protect a strong and competitive American aerospace industrial base. But, in addition to that, I am very much concerned about the ability of the Air National Guard to continue to operate amid the looming shortfalls and the age of our aircraft. Mr. Secretary and General, let me dive right in. I am afraid we are looking at a backdoor base realignment and closure (BRAC) on the Air Guard. In my view, no progress or proactive steps have been taken to address, substantively, the looming tactical airpower (TACAIR) bathtub in the Air Guard. That’s first. All I continue to hear about are plans to reduce the size of the Air Force and the Air Guard. The Air Guard cannot be expected to give up aircraft and missions in the near term, only to be told they will eventually be provided with new, still undefined missions later, or be told that the Joint Strike Fighter replacements are coming, when we all know they will not be available in time. Such a leap of faith will result in the atrophy of a number of Air Guard units that won’t be able to train or recruit without viable replacement missions or aircraft. But, I’m afraid that’s exactly what we are doing. That’s why I’ve labeled it, I believe appropriately, as a ‘‘backdoor BRAC’’ of Air Na- tional Guard units. This backdoor BRAC will threaten our ability to police our Nation’s skies, a roll of the dice with our national security that I’m not willing to take, and I don’t think anybody here should. Further, I don’t subscribe to the overall line of thinking that we have to accept a smaller Air Force. It’s my strong view the false- hood is being driven by a thorough—not by a thorough analysis of foreseeable threats and requirements, but by self-fulfilling Pen- tagon budget studies and the extreme cost overruns and scheduling delays of a major program like JSF. Delays in cost growth from the JSF are sucking all the oxygen and resources out of other procurement needs. That results in our pilots flying aircraft that are, in many instances, older than they are. That ought to be unacceptable for the world’s greatest super- power. 368 In addition, the threat to the Air Guard and their critical missions to defend our Nation’s skies, going down the current path is a threat to our defense industrial base. The Air Force long-term budget contains few new programs of the kind required to retain engineers and designers that will preserve our air dominance in the years to come. Secretary Gates killed or scaled back almost 50 major U.S. defense programs last year, but still poured billions more into a program that has had a Nunn-McCurdy breach—a big-time breach, a huge cost overrun on the JSF. Without other new programs, aerospace engineering and design skills will atrophy. With the atrophy of the defense industrial base which we’ve been seeing since the 1990s, innovation will be stifled and a lack of competition will lead to higher price tags for new platforms that will be procured in smaller numbers. Does that sound familiar? With the threats to our long-term and short-term security ema- nating from all over the globe, and for places where 4.5 aircraft could meet the needs, I think it’s important to maintain a quantitative edge, as well as it’s important to maintain a quality edge. As capable as an F–22 is, it cannot be in three places at once. With that, Mr. Chair, I thank you and await the questions. Chairman INOUYE. Senator Leahy. STATEMENT OF SENATOR PATRICK J. LEAHY Senator LEAHY. Well, thank you, Mr. Chairman. And because of the new Supreme Court nominee, I have to go to meet up with her. But, I am delighted to see Secretary Donley and General Schwartz here. I have some questions I will submit for the record, with the Chairman’s—— Chairman INOUYE. It will be. Senator LEAHY [continuing]. Permission, Mr. Secretary, on community basing, especially the initiative in Burlington, Vermont. I’m very interested in knowing the answers. I hope that you could call me with the answers, or that your staff could work with mine to provide a response. And, of course, the so-called fighter bathtub issue that’s looming over the Guard—Senator Bond and I are cochairs of the Senate Na- tional Guard Caucus, and we’re both concerned about that. So, with your permission, Mr. Chairman, I will submit those questions for the record. I’m delighted to see Secretary Donley here. We’ve had a chance to chat on other occasions. It’s great to be here with him, and also with General Schwartz, who I’ve talked with on other occasions. Chairman INOUYE. Thank you. Senator Dorgan. STATEMENT OF SENATOR BYRON L. DORGAN Senator DORGAN. Mr. Chairman, thank you very much. I know that the Air Force has been through a couple of years of some—2 or 3 years of some real turbulence and difficulties and em- barrassments, and so on. And I just want to observe that I think the Secretary and the Chief have taken action to provide some sta- 369 bility. And I think things are on track in the Air Force. I appreciate, very much, their leadership. And even while saying that, I don’t want to cast aspersions on some of the others. I understand the captain of the ship is responsible for all that goes on in the ship, but the Air Force has had some good leadership over time, and I appreciate the willingness of the Secretary and the Chief to serve. Let me just say, I think the least surprising development in the last decade was: If you go to war and wage war for 8 years halfway around the world, and don’t pay for one penny of it, but just put it all on emergency spending, don’t ask the taxpayers to pay for it; charge it all as emergency spending—that someday you’re going to run up against defense with no gate. And that’s what Secretary Gates, I think, was saying the other day. This country can’t continue to do that. Its fiscal policy is absurd. We know better than this. And so, it puts an enormous pinch on services like the Air Force. My colleague raised a point about the new fighter. I mean, I think it is the case that all of us are concerned about the per-unit costs of the planes we’re buying. It’s not just planes. It’s every piece of equipment for the military. The per-unit cost continues to go up, up, and up. And that’s a great concern. But, I think Secretary Gates is saying the right things publicly, and with some courage. We’ve got to address all of these issues. This will not be a time, going forward, like the time that we’ve just seen. And wherever—whatever someone needs, ‘‘It’s fine. We’ll just pay for it and charge it.’’ Let me also say that I visited Creech Air Force Base last Friday, and had briefings on the unmanned aerial vehicles (UAVs). And it’s very interesting to me, as it has always been, that that represents, in many ways, the future of the Air Force. I mean, we fly, as you— all of us know, fighter missions out of the most unusual places in this country, real time, with unmanned aerial vehicles, halfway around the world, with the most sophisticated satellite, and so on. It’s pretty unbelievable. And I also think that much of what we’re going to be discussing, going forward, is what this new paradigm—this new unmanned aerial vehicle system means, in terms of how we fight, how we train, and all of those issues. And I just want to say, General Schwartz, the folks that you have at Creech, the commander and others, are really first-rate. And I had a chance to observe those who are flying the UAVs, and I came away mightily impressed, as I always do, but especially, I think—it’s the first place where we’ve had these unmanned aerial vehicle operations, I think, starting maybe 8, 9 years ago. But, it’s an extraordinary place. So, I have a few questions. I’m not sure I’m going to be able to stay for all of it, today. But, I thank you, Mr. Chairman, for inviting the Secretary and the Chief. Chairman INOUYE. Thank you. The vice chairman. 370

STATEMENT OF SENATOR THAD COCHRAN Senator COCHRAN. Mr. Chairman, thank you very much for convening the hearing. I join you in welcoming our distinguished witnesses at this hearing. They have very important responsibilities in managing the Air Force and making sure that we are protecting our national security interests with the best there is. And we appreciate that very much. Thank you. Chairman INOUYE. Thank you. Senator Murray. STATEMENT OF SENATOR PATTY MURRAY Senator MURRAY. Mr. Chairman, thank you so much for having this hearing. And, Secretary Donley, I join with Senator Bond in thanking you for joining us for our first meeting of the Aerospace Caucus. It’s extremely important that we begin to look at long-term planning to make sure that we maintain our aerospace industry in this country, for all the reasons that are important to our military, as well as our economy and in the future. And I appreciate your participation in that. I do have a number of questions, and I will use those during my question time. And again, welcome, to both of you. And thank you for having this hearing. Chairman INOUYE. Thank you. And now, Mr. Secretary. SUMMARY STATEMENT OF HON. MICHAEL B. DONLEY Mr. DONLEY. Thank you, Mr. Chairman, members of the subcommittee. It is truly an honor to be here today representing almost 680,000 Active Duty, Guard, and Reserve airmen and Air Force civilians. I’m also honored to be here with General Schwartz, who has been a tremendous partner and a tireless public servant, especially over the past couple of years, in addition to a very long and distinguished career, prior to this assignment. I’m pleased to report, today, that America’s Air Force continues to make progress in strengthening our contributions as part of the joint team and the overall excellence that is the hallmark of our service. We’re requesting $150 billion in our baseline budget, and $20.8 billion in the overseas contingency operations supplemental appropriation to support this work. In the past year, and planning for the future, we’ve focused on balancing our resources and risk among the four objectives outlined by Secretary Gates in the 2010 QDR. FOUR OBJECTIVES IN 2010 QDR First, as the chairman noted, we must prevail in today’s wars. Your Air Force understands the gravity of the situation in Afghani- stan. And, as we continue to responsibly draw down our forces in Iraq, we are committed to rapidly fielding the needed capabilities 371 for the joint team, such as surging ISR assets into the theater and maximizing air mobility to accelerate the flow of forces into Af- ghanistan. Second, we must prevent and deter conflict across the spectrum of warfare. And as we assess potential implications of the Nuclear Posture Review (NPR) and the new Strategic Arms Reduction (START) Treaty, we continue concentrating on the safety, security, and sustainment of two legs of the Nation’s nuclear arsenal. Last year, we stood up the Air Force Global Strike Command, and we now have realigned our intercontinental ballistic missile (ICBM) and nuclear capable bomber wings under the control of a single commander. We also realigned responsibilities to the Nu- clear Weapons Center to consolidate the management of all our nuclear weapon sustainment activities. And to increase our engagement across the world, we’re building partner capacity, in Afghanistan and Iraq especially, and developing a training framework that emphasizes light attack and mobility that can benefit other nations. Third, we must prepare to defeat adversaries and to succeed in a wide range of conflicts. We need to ensure we’re providing the right capabilities with our strategic airlift and ISR platforms, and ensure that our space-based assets continue to deliver needed capabilities into the future. In addition, the last two decades of sustained operations have strained our weapons systems. We continue to determine which aircraft we will modernize and sustain, and which we must retire and recapitalize. One of our primary efforts includes retiring and recapitalizing many of our legacy fighters and tankers, and replacing them with the F–35 and the KC–X. These decisions require tough choices as well as the ability to quickly field systems that meet warfighter needs at an affordable price. Because acquisition underpins this effort, we’re continuing our work to recapture excellence in this area, as well. And in the past year, we’ve made significant strides in reforming our internal processes. We’ve added more program executive officers and are growing our acquisition workforce by several thousand professionals over the next 5 years. Finally, we need to preserve and to enhance our All Volunteer Force. Airmen are our most valuable resource, and they have performed superbly in every mission and deployment they’ve undertaken. YEAR OF THE AIR FORCE FAMILY With the understanding that their families serve alongside them, in July of last year, the Chief of Staff, the chief master sergeant of the Air Force, and I began a year-long focus on our men and women, and their families. This ‘‘Year of the Air Force Family’’ recognizes their sacrifices and looks to determine how we can better support, develop, house, and educate them. As this effort draws to a close later this summer, we’re determining which programs are performing well, and where we can do better. Mr. Chairman, your Air Force is performing exceptionally well in supporting the current fights; responding to growing demands and shifting personnel priorities on short notice. But, we’re increasingly 372 stressed inside the continental United States. Rebuilding nuclear expertise will require continued determination and patience. And we are taking more risk in nondeployed force readiness. And, as you mentioned, Mr. Chairman, we’re facing significant challenges in modernization and in our infrastructure. At the same time, however, we are developing and fielding new technologies and capabilities that bode very well for our future. I can tell you, after a recent trip to the U.S. Central Command area, that we are recruiting and training some incredible airmen. Gen- eral Schwartz and I can, again, confirm that the Air Force is blessed with an outstanding civilian and military leadership team to help us address these challenges. Our priorities are clear. We must make the most of those resources available to balance capability against risk, balancing winning today’s wars against preparing for tomorrow’s. We need to prevail in today’s fights, and we continue to add capability in every way possible to help ensure the success of ongoing conflicts. We must prevent and deter future conflict, where we can, and continue to be prepared for and succeed across this full spectrum of conflict. And finally, we must continue to preserve our airmen and their families, for they are truly our hedge against an uncertain future. PREPARED STATEMENT We’re very grateful for the subcommittee’s support in this work, and we look forward to working with you and to answering your questions today. Thank you, Mr. Chairman. Chairman INOUYE. Thank you very much, Mr. Secretary. [The statement follows:]

PREPARED STATEMENT OF HON. MICHAEL B. DONLEY The Air Force Posture Statement presents our vision of Global Vigilance, Reach and Power as a vital component of the Joint team, defending our National interests, and guided by our core values of Integrity First, Service Before Self, and Excellence in All We Do.

INTRODUCTION Today, the United States confronts a dynamic international environment marked by security challenges of unprecedented diversity. Along with our Joint partners, the Air Force will defend and advance the interests of the United States by providing unique capabilities to succeed in current conflicts while preparing to counter future threats to our national security. Over the last year, the Air Force made great strides in strengthening the precision and reliability that is our hallmark.

STRATEGIC FOCUS This year offers an opportunity to fully integrate our Service posture with a new National Security Strategy, the Department of Defense Quadrennial Defense Re- view, and strategic reviews of the Nation’s space, nuclear, and ballistic missile defense postures. Balance is the defining principle linking this budget request to our strategic guidance. In the 2010 Quadrennial Defense Review, the Secretary of Defense established four U.S. defense objectives to guide our current actions as well as to plan for the future: prevail in today’s wars, prevent and deter conflict, prepare to defeat adversaries and succeed in a wide range of contingencies, and preserve and enhance the all-volunteer force. In accordance with this guidance, the Air Force developed the 2011 budget request to enhance our capabilities to meet these objectives, while balancing risk appropriately. As the future security environment will require a range of agile and flexible capabilities, investments for today’s conflict will also support our efforts to prepare, prevent, and prevail, and preserve well into the future. 373

Prevail in Today’s Wars.—Our investments in intelligence, surveillance, and reconnaissance, as well as airlift, command and control, and building partner capacity reinforce the prominence of this priority in our budget request. In addition, nearly 30,000 deployed Airmen daily provide key capabilities in direct support of combat operations. Prevent and Deter Conflict.—The Air Force made significant resource and cultural investments in reinvigorating our portion of the Nation’s nuclear deterrence over the past 18 months. We are now institutionalizing these successes to ensure the highest standards across the nuclear enterprise. Our initial investments in a family of long-range strike capabilities mark our commitment to sustaining power projection capabilities for the next several decades. Prepare to Defeat Adversaries and Succeed in a Wide Range of Contingencies.— This priority directly reflects the Air Force emphasis on balancing our commitments to today’s conflicts against preparing for mid- and long-term risks. Awarding a contract this year to recapitalize our aging tanker force is our top acquisition priority. Similarly, the F–35 will be the workhorse of the fighter force for decades to come. Our investment in this program is timed with other modernization initiatives and divestment plans to ensure sufficient capabilities are available to deter and defeat potential enemies. Preserve and Enhance the All-Volunteer Force.—Preserving and enhancing our all- volunteer force provides the foundation required for our flexible and agile posture. This budget reflects a commitment to enhancing our force through education and training, while also bolstering the overall quality of life of Airmen and their families.

STRATEGY TO RESOURCES As we prepared the budget request described by this Posture Statement, we structured our resource choices by balancing the twelve Air Force Core Functions across the near- and long-term. When considered together, the Core Functions encompass the full range of Air Force capabilities, and serve as the framework for this Posture Statement. While this document describes the core functions individually, we recognize their inherent interdependence within not just the Air Force, but also within the Joint force and the whole of government. Air Force Core Functions.—Nuclear deterrence operations; air superiority; space superiority; cyberspace superiority; global precision attack; rapid global mobility; special operations; global integrated ISR; command and control; personnel recovery; building partnerships; and agile combat support.

NUCLEAR DETERRENCE OPERATIONS Since its inception, the Air Force has served as a proud and disciplined steward of a large portion of the Nation’s nuclear arsenal. We steadfastly maintain and secure nuclear weapons to deter potential adversaries, and to assure our partners that we are a reliable force providing global stability. The first Air Force priority during the last 2 years has been to reinvigorate the stewardship, accountability, compliance, and precision within the nuclear enterprise. This mission demands perfection. Last year we reorganized our nuclear forces, con- solidating responsibility into a clear chain of command. All nuclear operations are under the command of the Air Force Global Strike Command and all sustainment activities are controlled by the Air Force Nuclear Weapons Center. We also added a fourth B–52 squadron to enhance nuclear surety through greater mission focus. We continued these advancements in fiscal year 2010 by reassigning Interconti- nental Ballistic Missile (ICBM) and nuclear bomber forces to Air Force Global Strike Command as it proceeds toward full operational capability. The fiscal year 2011 budget request continues to invest in sustaining the Air Force’s ICBM and bomber fleets. We will invest $295 million across the FYDP to replace fuzing mechanisms, and to sustain test equipment and environmental control systems for the aging, but capable, Minuteman III ICBM weapon system. As we begin work to develop a future Long Range Strike capability, we recognize the need to continue investing in our legacy bomber fleets, including nearly $800 million for modernization. This budget request provides the B–52, initially designed in the early 1950s, with an internal precision-guided weapons capability, a new radar, and a modern and effective anti-skid system. This request funds modernization of B–2 analog defensive systems to ensure continued survivability against increasingly capable air defense systems. Additionally, the UH–1N replacement program supporting missile launch complexes is on track and we anticipate initial operating capability by fiscal year 2015. 374

AIR SUPERIORITY Air superiority is a necessary precondition for most U.S. military operations. American ground forces have operated without fear of enemy aircraft since 1953. Al- though we operate in uncontested airspace in current conflicts, we cannot assume this will be the case in the future. The emergence of modern air defenses challenges the ability of the Air Force to achieve air superiority. Potential adversaries are leveraging readily accessible technologies by modifying existing airframes with improved radars, sensors, jammers, and weapons. In addition, several nations are pursuing fifth-generation aircraft capable of all-aspect, low-observable signatures, and fully integrated avionics and sensors. Adversary nations are also turning to advanced surface-to-air missiles to augment or even substitute for aircraft modernization efforts. The proliferation of these sophisticated and increasingly affordable weapons presents an area denial capability that challenges our legacy fleet. As the range of potential threats evolves, the Air Force will rely on the F–22 Raptor as the workhorse of the air superiority fighter force for the foreseeable future. Comple- menting our 187 modernized F–22s, we will continue to rely on F–15C/D aircraft to provide an important component of our air superiority capability. Our fiscal year 2010 budget included plans to accelerate the retirement of some legacy fighter aircraft to pave the way for a smaller but more capable fighter force. As we work with the Congress to execute this important plan, we continue to aggressively modernize our air superiority fleet, including upgrading fielded F–22s to ensure fleet commonality with current deliveries. Additionally, we began modernizing 176 F–15Cs with the new APG–63(v)3 Active Electronically Scanned Array (AESA) radar. Along with these modifications, we are continuing the development and procurement of the AIM–9X and AIM–120D air-to-air missiles. The fiscal year 2011 budget requests $12.5 billion in the FYDP to sustain Amer- ica’s air superiority advantage. To continue F–22 modifications, this request includes $1.34 billion to continue fleet commonality upgrades, improving reliability and maintainability, and adding training enhancements for the fleet. Building on the multi-role nature of our most advanced aircraft, this request also includes $1.19 billion to add precision attack capabilities such as the Small Diameter Bomb. The Air Force will also continue the development and procurement of air-to-air munitions and defenses for the F–22 such as the AIM–9X, AIM–120D, and electronic warfare capabilities. To sustain our legacy aircraft viability, we included $92 million to continue the upgrades and modifications to the new F–15 AESA radar. Recog- nizing that Electronic Warfare remains an integral part of air superiority, we request $251 million in fiscal year 2011 for upgrades to the EC–130H Compass Call fleet. This request includes the conversion of an additional EC–130H, as well as a combined flight deck and mission crew simulator to increase training capacity.

SPACE SUPERIORITY America’s ability to operate across the spectrum of conflict relies heavily on space capabilities developed and operated by the Air Force. We support the Joint force by developing, integrating, and operating in six key mission areas: missile warning; space situational awareness (SSA); military satellite communications; positioning, navigation and timing; space access; and weather. To enhance space support to the Joint force, we are increasing communications capability in fiscal year 2010 through two satellite communications programs, the Wideband Global Satellite (WGS) program to replace the Defense Satellite Commu- nications System (DSCS), and Advanced Extremely High Frequency system for protected communications. We launched the second and third WGS satellites in fiscal year 2010; each WGS satellite provides the equivalent capacity of the entire legacy DSCS constellation. Additionally, the second on-orbit Space-Based Infrared System Highly Elliptical Orbit payload was fully certified by United States Strategic Com- mand to perform strategic missile warning. Finally, spacelift remains the backbone for national security space with a record 64 consecutive successful missions. The fiscal year 2011 budget request for $10.9 billion will improve our stewardship of space with investment in space and space-related support systems. With these resources, we will field several first-of-their-kind systems—Global Positioning System Block IIF, Space Based Space Surveillance System, and Advanced Extremely High Frequency satellite communications system. This request proposes $1.2 billion for the Evolved Expendable Launch Vehicle program, $1.8 billion for the Space Based Infrared System, and $1.3 billion for GPS. We also included $135 million for Joint Space Operation Center Mission System to improve SSA capabilities, and $94 million for the Operationally Responsive Space program to pursue innovative capabilities that can be rapidly developed and fielded in months rather than years. We request $577 million to fully fund WGS to meet combatant commander bandwidth re- 375 quirements. Moreover, we will continue to maintain SSA ground-based systems and explore space-based capabilities to ensure our continued freedom to operate in this domain.

CYBERSPACE SUPERIORITY Cyber threats ranging from individual hackers to criminal organizations to state- sponsored cyber intrusions can challenge access to, and use of, this domain. Al- though the freedom to operate in the cyber domain is a precondition for our increasingly networked force, many of our potential adversaries are similarly adopting information-enabled technology, rendering them vulnerable to cyber attack as well. Threats to freedom of access to the cyber domain present both challenges and opportunities. In fiscal year 2010 we continued the development and institutionalization of cyberspace capabilities and integration into the Joint cyberspace structure. The newly activated 24th Air Force, the first Numbered Air Force dedicated to cyberspace operations, recently achieved initial operational capability and has been designated the Air Force component for the sub-unified U.S. Cyber Command. We are also focusing on cyber personnel by normalizing the cyber career path and adding technical education courses. The fiscal year 2011 budget request reflects a continued commitment to cyber superiority. We request $31 million for expanded rapid cyber acquisition capabilities to keep pace with dynamic adversaries and fast-paced advances in technology. In support of the national cyber effort, this budget request dedicates $104 million to support operations and leased space for headquarters staff at the sub-unified U.S. Cyber Command. Additionally, we propose adding $15 million and additional manpower over the next 5 years to increase the investigative and law enforcement aspects of cyberspace defense.

GLOBAL PRECISION ATTACK Global Precision Attack is the ability to hold any target at risk, across the air, land, and sea domains. Many of our global precision attack forces are meeting the current requirements of ongoing contingency operations by performing precision strike and intelligence, surveillance, and reconnaissance (ISR) support roles. In the longer term, however, the proliferation of area denial and anti-access capabilities will challenge the ability of current fourth-generation fighters and legacy bombers to penetrate contested airspace. The Air Force budget request in fiscal year 2010 recognized these developments and continued improvements to aircraft and weapons capabilities. This year, we will take delivery of 10 F–35s for developmental testing and to train test pilots. We are also modernizing legacy fighter aircraft to maintain sufficient capability and capacity until the F–35 fleet is fully operational, and are continuing to develop programs for preferred air-to-ground weapons. Upon completion of the required reports to the Congress later this year, we will implement the planned reduction of 257 legacy fighters. We have had mixed results in test drops of the Massive Ordnance Pene- trator; however, we are closely monitoring the progress of this important capability, and future successes likely will result in a reprogramming request to accelerate its development in fiscal year 2010. Finally, continued development of the second increment of the Small Diameter Bomb will give the Air Force even greater capability and flexibility. Our $14.4 billion Global Precision Attack request for fiscal year 2011 reflects a balanced approach across the portfolio, prioritizing investment in fifth-generation aircraft while sustaining legacy platforms as a bridge to the F–35. F–35 Joint Strike Fighter The multi-role F–35 is a critical element of the Air Force’s future precision attack capability. In addition to complementing the F–22’s world class air superiority capabilities, the F–35 is designed to penetrate air defenses and deliver a wide range of precision munitions. This modern, fifth-generation aircraft brings the added benefit of increased allied interoperability and cost-sharing across services and partner nations. Working in close collaboration with DOD, the F–35 program team realized a number of accomplishments over the last year, to include the first flight of the first optimized conventional take-off and landing (CTOL) Joint Strike Fighter (JSF) variant—aircraft AF–1. Despite these important accomplishments, the program is experiencing program challenges as it transitions from development to production. Last year, DOD conducted multiple, independent reviews to assess the impact of these challenges on the 376 program’s cost, schedule, and technical performance. The results were consistent with a previous fiscal year 2008 DOD independent assessment that projected a cost increase and schedule slip. The challenges being experienced are not unusual for this phase of a major program. However, we are disappointed by the contractor’s failure to deliver flight test aircraft as scheduled during the past year. The result of the late deliveries will be a delay in the flight test program. Although there appear to be recent improvements, the contractor also has been experiencing assembly inefficiencies that must be corrected to support higher production rates. In response to the challenges still facing the program and the findings of the independent reviews, we have taken numerous management actions to reduce risk. Most significantly we have determined that it is prudent to adjust the schedule and funding to levels consistent with the most recent independent estimates. These cost and schedule adjustments require that we initiate the process to confirm the program is in breach of the Nunn-McCurdy Act criteria, and details will be reported later this spring. The F–35 is our largest and most important program and we are dedicated to successfully delivering these aircraft to both the United States and to our international partners in this effort. The Air Force fiscal year 2011 budget includes $5.6 billion for continued development and procurement of 22 CTOL production aircraft. Long-range Strike Investments in our B–52 and B–2 fleets sustain nuclear deterrence operations as well as conventional global precision attack capabilities in the near-term, but we are adding research and development funds to accelerate development of enhanced long- range strike capabilities. Building upon insights developed during the Quadrennial Defense Review (QDR), the Secretary of Defense has ordered a follow-on study to determine what combination of Joint persistent surveillance, electronic warfare, and precision-attack capabilities will be best suited to support U.S. power projection operations over the next two to three decades. The study will examine both penetrating platforms and stand-off weapon options. As part of this assessment, the Air Force is reviewing options for fielding survivable, long-range surveillance and strike aircraft as part of a comprehensive, phased plan to modernize the bomber force. Ad- ditionally, the Navy and the Air Force are cooperatively assessing alternatives for a new Joint cruise missile. Finally, the Department of Defense also plans to analyze conventional prompt global strike prototypes and will assess the effects that these systems, if deployed, might have on strategic stability.

RAPID GLOBAL MOBILITY The Air Force is committed to providing unmatched airlift and air refueling capability to the nation. Air Force mobility forces provide an essential deployment and sustainment capability for the Joint force, delivering personnel, equipment, and supplies necessary for missions ranging from conflict to humanitarian relief. We are releasing the Request for Proposal for a KC–X replacement tanker in early 2010, and will aggressively work toward awarding a contract later this year. Addi- tionally, we completed the successful operational testing of the C–5 Reliability En- hancement and Re-engine Program (RERP) and will induct two more C–5Bs into low-rate initial production. For tactical airlift, we recently concluded a test of our Direct Support airlift concept and continue to work with the Army to rapidly and smartly transfer the C–27J program to the Air Force. The fiscal year 2011 budget reflects a balanced approach across the tanker and airlift portfolios, which prioritizes recapitalization of the oldest aircraft while ensuring the continued viability of the legacy fleet. Investments in tanker capability are heavily weighted towards the KC–X program—our top acquisition priority—and represent $11.7 billion in the FYDP. However, while moving aggressively to recapitalize the tanker fleet, we must also ensure the continued health of legacy aircraft. This budget request includes $680 million in the FYDP for airspace access modifications and sustainment of the KC–10 and KC–135 fleets. The Air Force Airlift budget request is focused on meeting mobility requirements in the most cost efficient way possible, recapitalizing only the oldest airlift aircraft. To ensure continued access to all airspace, this budget continues to modernize and modify C–5s and C–130Hs through Avionics Modernization Programs, and upgrades C–5B/Cs with RERP. To complete the recapitalization of C–130Es, we request $1.8 billion over the next 5 years to procure 24 C–130Js. Additionally, in accordance with the preliminary results of the Mobility Capabilities and Requirements Study 2016, and subject to authorization by the Congress, we intend to retire some of the oldest, least capable C–5As and C–130H1s. We have also requested $38.9 million in fiscal year 2011 to transition from C–17 procurement to sustainment. 377

SPECIAL OPERATIONS Air Force special operations capabilities play a vital role in supporting U.S. Spe- cial Operations Command (USSOCOM) and geographic combatant commanders. As the Department of Defense increasingly develops irregular warfare capabilities, the Air Force is investing in special operations airlift, close air support, foreign internal defense, and intelligence, surveillance, and reconnaissance capabilities. In fiscal year 2010 we focused on growing and recapitalizing the special operations aircraft inventory. By the end of the fiscal year, three MC–130W Combat Spear aircraft will be modified with the Precision Strike Package to provide additional armed overwatch capability for SOF forces. Additionally, we will deliver the 16th of 50 CV–22s. This fiscal year 2011 budget proposal includes $6.7 billion through the FYDP to continue growing and recapitalizing the Air Force Special Operations Command (AFSOC). In fiscal year 2011 we will procure five additional CV–22s and five MC– 130Js for $1.1 billion. This request also includes $1.6 billion in the FYDP to start recapitalizing our AC–130H aircraft. We will rapidly recapitalize these aging aircraft through the procurement of 16 additional MC–130Js, modified with the proven Precision Strike Package. In fiscal year 2011 we will also increase AFSOC’s manpower by 258 personnel by fiscal year 2015 to support the addition of 16 fixed-wing mobility and two rotary-wing aircraft.

GLOBAL INTELLIGENCE, SURVEILLANCE, AND RECONNAISSANCE The Air Force continues to rapidly increase its Intelligence, Surveillance, and Re- connaissance (ISR) capability and capacity to support combat operations. Air Force ISR provides timely, fused, and actionable intelligence to the Joint force, from forward deployed locations and globally distributed centers around the globe. The exceptional operational value of Air Force ISR assets has led Joint force commanders in Iraq, Afghanistan, and the Horn of Africa to continually increase their requests for these forces. To help meet this demand, the Air Force currently has more than 90 percent of all available ISR assets deployed. In fiscal year 2010, we are quantitatively and qualitatively increasing aircraft, sensors, data links, ground stations, and personnel to address emergent requirements. Over the last 2 years, the Air Force increased the number of remotely piloted aircraft (RPA) fielded by 330 percent. We invested in a Wide Area Airborne Surveil- lance (WAAS) system for new and existing MQ–9s to provide up to 50 video streams per sensor within a few years. By the summer of fiscal year 2010, a quick reaction capability version of WAAS known as Gorgon Stare will provide 10 video streams per MQ–9. Any ROVER-equipped ground force will be able to receive any of these feeds. We also added four RQ–4s, and graduated our first class of RPA-only pilots. Early in fiscal year 2010, we proposed a shift in the nomenclature from ‘‘unmanned aircraft systems’’ (or UAS) to ‘‘remotely piloted aircraft’’ as part of normalizing this capability within the Air Force manpower structure and culture. We will also maintain our current JSTARS-based Ground Moving Target Indicator (GMTI) capability as we begin an Analysis of Alternatives to determine the future of GMTI. To complement remotely piloted capabilities, we are deploying MC–12W Project Liberty aircraft to the theater as fast as they can be delivered from the factory. This program progressed from ‘‘concept to combat’’ in a record 9 months, and has a deployed maintenance availability rate well above 90 percent. Because analysis transforms data into actionable intelligence, we are shifting approximately 3,600 of the 4,100 manpower billets recaptured from the early retirement of legacy fighters to support RPA operations, and the processing, exploitation, and dissemination of intelligence collected by manned and remotely piloted aircraft. We also doubled the number of ISR liaison officers assigned to deployed ground forces to ensure the seamless integration of ISR collection and exploitation assets. Our fiscal year 2011 budget proposal reflects the Joint force emphasis on ISR capacity, and builds on progress made in fiscal year 2010. The Air Force will reach 50 RPA continuous, combat air patrols (CAPs) in theater by the end of fiscal year 2011. The budget request increases MC–12W funding to normalize training and basing posture, adds Wide Area Airborne Surveillance capability, and increases the total number of our RPA platforms to enable fielding up to 65 CAPs by the end of fiscal year 2013. As we request additional RQ–4 Global Hawks for high altitude ISR, we also intend to continue operating the U–2 at least throughout fiscal year 2013 as a risk mitigation effort. We will sustain our ISR processing, exploitation, and dissemination in the Distributed Common Ground System, providing critical distributed analysis without having to forward deploy more forces. 378

COMMAND AND CONTROL Theater-wide command and control (C2) enables efficient and effective exploitation of the air, space, and cyber domain. The Air Force maintains significant C2 capabilities at the theater level. However, the highly decentralized nature of irregular warfare also places increased demands on lower echelons of command. Matching the range and flexibility of air, space, and cyberspace power to effectively meet tactical requirements requires a linked C2 structure at all echelons. This year, we are expanding our efforts to provide C2 at the tactical, operational, and strategic levels. In fiscal year 2011, the Air Force is requesting $30 million across the FYDP to fund equipment and assured communications for U.S. Strategic Command’s Distributed Command and Control Node (DC2N), U.S. Northern Com- mand’s National Capital Region—Integrated Air Defense (NCR–IADS), and U.S. Af- rica Command’s expanding air operations center. Tactically, we are increasing training pipelines for Joint Terminal Attack Controllers (JTACs), establishing an Air Li- aison Officer career field, fielding advanced video downlink capabilities, and adding airborne radio and datalink gateways to improve the connectivity of air support operations centers and JTACS. In fiscal year 2011, the Air Force request also includes modernization and sustainment of both airborne and ground-based C2 systems. For Air Force airborne C2, we request $275 million for the E–3 Block 40/45 upgrade program. This upgrade modernizes a 1970s-era computer network, eliminates many components that are no longer manufactured, and adds avionics to comply with Global Air Traffic Manage- ment standards. To improve ground-based tactical air control operations, we are increasing manpower in the control and reporting centers and investing $51.5 million with the U.S. Marine Corps for a follow-on ground-based radar capability supporting air and missile defense. This Three-Dimensional Expeditionary Long-Range Radar (3DELRR) will be the future long-range, ground-based sensor for detecting, identifying, tracking, and reporting aircraft and missiles.

PERSONNEL RECOVERY Personnel recovery (PR) remains an important commitment the Air Force makes to the Joint force. The increased utilization of military and civilian personnel in support of Overseas Contingency Operations (OCO) has dramatically increased the number of individuals who may find themselves isolated. This has in-turn created an increasing demand for Air Force rescue forces beyond the combat search and rescue mission. Air Force PR forces are fully engaged in Iraq, Afghanistan, and the Horn of Africa, accomplishing crucial medical and casualty evacuation missions for U.S. and Coalition military and civilian personnel. This year, we will continue to surge critical personnel recovery capability to the field, and will start replacing the aging fleet. To bring the fleet back to its original size of 112 HH–60Gs, we will put the first four operational loss replacement aircraft on contract. Additionally, we will deliver the first two HC–130J tanker aircraft, starting the replacement of the 1960s-era HC–130P fleet. The fiscal year 2011 budget request continues the replacement of operational losses and modernization of aging equipment. This request funds the last eight HH– 60G operational loss replacement aircraft by the end of fiscal year 2012. Addition- ally, we begin the process of recapitalizing the remaining fleet with the inclusion of $1.5 billion to procure 36 HH–60G replacement aircraft in the FYDP. We also continue our recapitalization of the HC–130P/N fleet with HC–130J aircraft. Fi- nally, we request $553 million in funding throughout the FYDP for the Guardian Angel program, which will standardize and modernize mission essential equipment for our pararescuemen.

BUILDING PARTNERSHIPS The Air Force continues to seek opportunities to develop partnerships around the world, and to enhance long-term capabilities through security cooperation. In the U.S. Central Command (USCENTCOM) area of responsibility, deployed Airmen are working with our Afghan and Iraqi partners to build a new Afghan National Army Air Corps and Iraqi Air Force to strengthen the ability of these nations to uphold the rule of law and defend their territories against violent, non-state actors. We are also working to further partnerships with more established allies with programs like the Joint Strike Fighter. Similarly, the third and final C–17 procured under the 12- nation Strategic Airlift Capability program was delivered in October 2009, helping to address a chronic shortage of strategic airlift among our European Allies. In fiscal year 2011, we will expand our capabilities to conduct building partner capacity (BPC) operations with partner air forces. Past experience has shown us 379 that we are more effective trainers when we operate the same platforms as our partners. To increase our interoperability, the Air Force requests resources to prepare to field the Light Mobility Aircraft (LiMA) in fiscal year 2012 and the Light Attack/ Armed Reconnaissance (LAAR) aircraft in fiscal year 2013. These aircraft will provide effective and affordable capabilities in the two most critical mission areas for partner air forces: lower-cost airlift and light strike/reconnaissance training. Addi- tionally, we will continue to foster BPC capability in our Contingency Response Groups. This request also includes $51 million to continue investing in the Strategic Airlift Capability program. Finally, we programmed $6.4 million annually across the FYDP for PACIFIC ANGEL humanitarian assistance missions in support of U.S. Pacific Command theater objectives.

AGILE COMBAT SUPPORT Agile combat support underpins the entire Air Force, from the development and training of Airmen to revitalizing processes in the acquisition enterprise. In terms of core functions, agile combat support reflects the largest portion of the Air Force budget proposal, totaling approximately $42 billion for personnel and training, installation support, logistics, and acquisition. Airmen and Families.—Over the last year we stabilized end strength. Retention rates have exceeded expectations, but we continue to progress toward our end strength goal of 332,200 active duty Airmen. In addition to stabilizing our end strength, we are also modernizing our training programs and aircraft. To better partner with the Joint and Coalition team, we will provide our Airmen with cultural and regional expertise and appropriate levels of foreign language training. We are also expanding foreign language instruction for officer commissioning programs at the Air Force Academy and in ROTC, encouraging cadets to take foreign language coursework and participate in language immersion and study programs abroad. This expanded training includes enhanced expeditionary skills training to prepare Air- men for deployment. Finally, as part of our effort to modernize training systems, we have established a program office to start the process of replacing the T–38 trainer with an advanced trainer capable of teaching pilots to fly the world’s most advanced fighter aircraft. Recognizing that family support programs must keep pace with the needs of Air- men and their families, we initiated the Year of the Air Force Family in July 2009. We plan to add enough capacity to our child development centers to eliminate the child care space deficit by the end of fiscal year 2012, provide better support to exceptional family member programs, and add 54 school liaison officers to Airmen and Family Readiness Centers to highlight and secure Air Force family needs with local school administrators. The Air Force continues to expand its efforts to improve the resiliency of Airmen and their families before and after deployments. This year we expanded deployment- related family education, coupling it with psychological screening and post-deployment health assessments. Additionally, we offer access to chaplains who provide pastoral care, and counselors and mental health providers trained in post-traumatic stress treatment at every base. We plan to further enhance support in 2010 by promoting and encouraging mental health assistance, and by providing at-risk deployers with tailored and targeted resiliency programs. To support this increased effort, we will enhance mental healthcareer field recruiting and retention through special pays and targeted retention bonuses. Acquisition Excellence.—The Air Force continues to make progress within the Ac- quisition Improvement Plan. In 2009, we hired over 2,000 personnel into the acquisition workforce and continued contractor-to-civilian conversions. The Air Force institutionalized early collaboration with acquisition system stakeholders, senior acquisition leadership certification of requirements, cost estimation improvements, and an improved budgeting process to enhance the probability of program successes. The multi-functional independent review teams conducted over 113 reviews, ensuring acquisition selections are correct and defendable. As part of our recent acquisition reorganization, we created 11 new program executive officer positions to reduce the span of control and increase their focus on program execution. These enhancements demonstrate our commitment to restoring the public’s trust in the Air Force’s ability to acquire the most technologically advanced weapon systems at a competitive cost. In the near-term, this more rigorous approach to acquisition is likely to identify problems and programmatic disconnects. In the medium- and long-term, it should yield significant improvements in Air Force stewardship of taxpayer resources. Energy.—As part of our institutional effort to consider energy management in all that we do, the Air Force requests $250 million for energy and water conservation 380 projects in fiscal year 2011. This investment will ensure we meet the President’s efficiency goals by 2015. In fiscal year 2010, the Air Force finalized an energy plan that directs the development and use of reliable alternative energy resources, and reduces the life-cycle costs of acquisition programs. Additionally, the plan recognizes that aviation operations account for over 80 percent of the energy used by the Air Force each year, and directs Airmen and mission planners to continue managing aviation fuel as an increasingly scarce resource. Military Construction.—The Air Force $1.3 billion military construction request is austere, but provides funding for new construction aligned with weapon system deliveries. Additionally, the budget request sustains our effort to provide quality housing for Airmen and their families. Finally, the Air Force remains focused on completing its BRAC 2005 program and continuing the legacy BRAC programs as well as the environmental clean-up at legacy BRAC locations. Strategic Basing.—In 2009, the Air Force implemented a Strategic Basing Process to ensure basing decisions are made in a manner that supports new weapon system acquisition and delivery schedules as well as organization activation milestones. The newly established Strategic Basing Executive Steering Group directs these actions to ensure a standard, repeatable, and transparent process in the evaluation of Air Force basing opportunities. We are currently using this process to conduct an enterprise-wide look at F–35 basing options. Logistics.—Air Force requirements for weapon system sustainment funding continue to grow as aircraft age. In the long term, the increasing requirements for sustaining an aging aircraft fleet pose budget challenges and force trade-offs. We protected direct warfighter support, irregular warfare capabilities, and the nuclear enterprise. Since this year’s budget includes a simultaneous OCO submission along with a base budget, the Air Force optimized its flying hour program funding to support only the peacetime flying hours we can fly, given the number of deployed Air- men and aircraft supporting Overseas Contingency Operations. Due to the volatile nature of fuel prices, reprogramming may be necessary to cover increased fuel costs. Over the longer term, enactment of the Department of Defense’s legislative proposal for the Refined Petroleum Products Marginal Expense Transfer Account would reduce disruptions to operations and investment programs by providing the Depart- ment of Defense flexibility to deal with fuel price fluctuations in the changing economy. The Air Force maintained its commitment to transforming logistics business practices, including total asset visibility and associated information technology, by protecting funds associated with fielding the first increment of the Expeditionary Combat Support System.

READINESS AND RESOURCING Our efforts over the last year continued to stress both people and platforms. Near- ly 40,000 of America’s Airmen are deployed to 263 locations across the globe, including 63 locations in the Middle East. In addition to deployed Airmen, nearly 130,000 Airmen support combatant commander requirements from their home station daily. These Airmen operate the Nation’s space and missile forces, process and exploit remotely collected ISR, provide national intelligence support, execute air sovereignty alert missions, and contribute in many other ways. To date, the Air Force has flown over 50,000 sorties supporting Operation Iraqi Freedom and almost 66,000 sorties supporting Operation Enduring Freedom. During this time the Air Force delivered over 1.73 million passengers and 606,000 tons of cargo, employed almost 1,980 tons of munitions, and transported nearly 70,000 total patients and 13,000 casualties from the USCENTCOM area of responsibility. In doing so, Airmen averaged nearly 330 sorties per day. To support the efforts of Airmen and to recruit and retain the highest quality Air Force members, this fiscal year 2011 budget request includes $29.3 billion in military personnel funding, to include a 1.4 percent pay increase. Our active component end strength will grow to 332,200 Airmen as the Reserve Component end strength increases to 71,200, and the Air National Guard end strength remains 106,700 in fiscal year 2011. Our recruiting and retention is strong, but we request $645 million for recruiting and retention bonuses targeted at critical wartime skills, including command and control, public affairs, contracting, pararescue, security forces, civil engineering, explosive ordnance disposal, medical, and special investigations.

SUMMARY The Air Force’s proposed fiscal year 2011 budget of $119.6 billion achieves the right balance between providing capabilities for today’s commitments and posturing for future challenges. The Air Force built this budget to best achieve the four strategic priorities outlined in the 2010 Quadrennial Defense Review: (1) prevail in to- 381 day’s wars; (2) prevent and deter conflict; (3) prepare to defeat adversaries and succeed in a wide range of contingencies; and (4) preserve and enhance the All-Volun- teer Force. Balancing requirements for today and tomorrow determined our recapitalization strategy. We chose to improve our existing capabilities whenever possible, and to pursue new systems when required. This recapitalization approach attempts to keep pace with threat developments and required capabilities, while ensuring stewardship of national resources. In developing this budget request, we also carefully pre- served and enhanced our comprehensive approach to taking care of Airmen and Air Force families. Chairman INOUYE. General Schwartz. STATEMENT OF GENERAL NORTON A. SCHWARTZ, CHIEF OF STAFF General SCHWARTZ. Mr. Chairman, Senator Cochran, members of the subcommittee, I’m proud to be here representing your Air Force with Secretary Donley. And let me begin by reaffirming that the United States Air Force is fully committed to effective stewardship of the resources that you and the Nation place in our trust. Guided by integrity, service, and excellence, our core values, America’s airmen, I think, are performing courageously every day with precision and with reliability on behalf of the American people. And this budget request supports these airmen and our continuing efforts to rebalance the force, to make difficult decisions on what and how we buy, and to sustain our needed contributions to the joint team. AIR FORCE FIVE PRIORITIES Secretary Donley and I established five priorities shortly after taking office to ensure that the entire force was focused on the right objectives. Most of our initial efforts centered on reaffirming our long-established standards of excellence, and recommitting ourselves to areas where our focus had waned. I am pleased to report to you today that our dedicated and talented airmen broadly understood our intent, and have delivered in meaningful fashion. Although these initial priorities were not designed to change from year to year, our progress in the nuclear enterprise is such that we can now shift our efforts to sustaining the progress that we’ve made. Thus, our first priority is to continue to strengthen excellence in our nuclear enterprise. The rigor of our nuclear surety inspections demonstrates a renewed commitment to the highest levels of performance. We must, and we will, do even more to ensure 100-percent precision and reliability in nuclear operations and logistics as close to 100 percent of the time as such a human endeavor will allow. For our second priority—and that is partnering with the joint and coalition team to win today’s fight—Secretary Donley mentioned several ways that—in which our airmen are providing critical air and space power for the joint and coalition team. Your airmen are also performing admirably wherever and whenever our joint teammates require, including providing battlefield medical support and evacuation, ordnance disposal, convoy security, and much more. Our third priority remains to develop and care for our airmen and their families. We initiated the ‘‘Year of the Air Force Family,’’ shortly after our testimony last year, in recognition of the vital role 382 that our families fulfill in mission accomplishment. Although their sacrifice is perhaps less conspicuous, their efforts are certainly no less noble, and their contributions are no less substantial. Modernizing our inventories, our organizations, and our training—our fourth priority—is among the most difficult tasks that our service has undertaken in these last 18 months. In order to achieve the balance that Secretary Gates envisioned for our force, we are compelled to decision and to action. This budget represents a continuation of that effort. We set forth a plan last year to accelerate the retirement of some of the older fighter aircraft. This year we are not retiring any additional fighters, but we are transitioning from some of our oldest and least capable C–130s and C–5s. We will modernize, where we can; but, where modernization no longer is cost effective, we will pursue recapitalization. KC–X is one such example. With the delivery of the request for proposal (RFP), our top acquisition effort, to procure the next generation refueling aircraft, passed another significant milestone. A similar imperative is the F–35. I want to underscore Secretary Donley’s comment by noting that this weapons system will be the workhorse driving our Air Force and our joint team forward. Long-range strike is the last program that I number among our top initiatives. The Air Force fully supports the development of the family of systems providing both penetrating and standoff capabilities for the next two or three decades, as described in the QDR. And finally, recapturing acquisition excellence—our fifth priority—is now only beginning to pay dividends with our acquisition improvement plan at the heart of our reform effort. While promising, the initial successes must continue for a number of years before we can declare victory on this front. We are fully aware that we must wring every bit of capability and value that we can from the systems that we procure; and so, this effort will require a sustained focus on acquisition excellence. Mr. Chairman, the Air Force will continue to provide our best military advice and stewardship, delivering global vigilance, reach, and power for America. Thank you for your continued support of the Air Force, and particularly for our airmen and their families. Sir, I look forward to your questions. Chairman INOUYE. I thank you very much, General Schwartz. Because of the change in our time schedules, regretfully, I would have to impose a 5-minute rule. And I’ll begin with the questioning. Mr. Secretary, because of emerging requirements on UAVs and cybersecurity missions, which will require thousands of trained personnel, how do you propose to meet this challenge of bringing together all these highly trained personnel? Mr. DONLEY. Mr. Chairman, this has been a tremendous challenge that the Air Force has stepped up to do. Our end strength is planned to be stable at about 330,000, but inside that Active Duty end strength, we are making the internal adjustments necessary to man the ISR systems and the intelligence support as it comes online. Most recently, we had proposed, and the Congress had approved last year, with some caveats, the reduction in fighter force struc- 383 ture, which we had laid on the table last year. That early retirement of about 250 legacy fighters allowed us to free up the manpower to put into the intelligence, surveillance, and reconnaissance area. And so, it is those internal adjustments, identifying career fields that are—where we have excess strength, and trying—and diverting that into areas that are growing—is a significant priority for us. Chairman INOUYE. So, you’re getting most of your personnel internally? Mr. DONLEY. Yes. The—we are. Of course, we continue to assess and recruit new airmen every year; that’s part of our normal operation. But, we are redirecting expertise, inside the Air Force, to these new missions. Chairman INOUYE. I thank you. If I may now ask General Schwartz: There’s a growing concern that there’d be a lack of missile warning satellite coverage because of continued delays in the Space-Based Infrared High Program (SBIRS). And, as you know, the Air Force terminated the third- generation missile warning program in fiscal year 2011. How do you plan to mitigate this potential gap in coverage? SBIRS PAYLOADS General SCHWARTZ. Mr. Chairman, we have two SBIRS payloads on—that’s the Space-Based Infrared System—payloads on orbit as we speak. And we intend to launch two more in the not-too-distant future to address General Chilton’s requirement for warning, and so on. The bottom line is that we believe we have a stable program, and one that will satisfy, with some margin, General Chilton’s needs. Chairman INOUYE. I thank you very much. May I now call upon Senator Cochran. Senator COCHRAN. Mr. Chairman, thank you for your leadership of our subcommittee, and for convening this important hearing. LEASING UNMANNED AERIAL VEHICLES Mr. Secretary, I’ve been informed that Australia, Germany, and France are leasing unmanned aerial vehicles to support their intelligence, surveillance, and reconnaissance mission in theater which continue to grow. Has the Air Force considered leasing, on a short- term basis, unmanned aerial vehicles to meet this demand, like many of our North Atlantic Treaty Organization (NATO) allies are doing? Mr. DONLEY. My understanding is that we have done that in very limited situations. Our allies took this approach for different reasons; in part, the urgent need that they had for these capabilities, and the need for them to take a bit longer time working through their internal defense and appropriations processes inside their governments. So, those were the motivations, as I understand it, behind their approach to leasing. Generally speaking, we prefer to buy. When one does a lease, a major and significant issue is indemnification for loss. And in our case, we had access to the manufacturers and the capability to buy this capability; we intend to keep this capability over a longer term. Generally speaking, buying, depending on the circumstances, 384 tends to be less expensive than leasing over the long term. So, we have taken the course that we should buy and own these capabilities. Senator COCHRAN. Okay. Thank you. General Schwartz, I understand that the combatant commanders outside of Central Command have requirements for intelligence, surveillance, and reconnaissance that are not being met. Would the Air Force consider leasing UAVs to meet this demand until requirements in the Central Command area of operation are reduced? General SCHWARTZ. Sir, we have a mandate to get to 50 24-hour orbits by the end of 2011. And the Secretary has mandated that we grow to 65 at the end of 2013. That is as much as we can do, both from a resource, a talent, and a manpower point of view. And so, my recommendation would be not to pursue lease. We are maximizing the production, for example, of the Reapers. And so, that will be the backbone of our remotely piloted aircraft (RPA) fleet, going forward. And given that’s the case, we think we are on, sort of, the maximum performance glidepath, here, to growing the capabilities so that we can satisfy the needs of other combatant commanders, whether that be in the Pacific or the Horn of Africa or elsewhere. Senator COCHRAN. General, your prepared statement indicates that the Air Force continues to modernize the air superiority fleet, including the F–15s, specifically. Could you describe the operational benefits of the F–15E radar modernization program; and tell us whether the Air Force has considered accelerating this effort? F–15E RADAR MODERNIZATION General SCHWARTZ. Sir, there are a couple of initiatives, both for the E-model F–15 as well as the air superiority F–15Cs and F– 15Ds. One of the things that the reduction in the fighter force structure allowed us to do was to reallocate resources to the remaining aircraft, the so-called ‘‘Golden Eagles,’’ if you will, where we will modify the radars with the active electronically scanned array capabilities. This technology is clearly superior to the me- chanically scanned radars that the airplanes currently possess— greater service volume, greater ability to track multiple targets, and so on. In addition, installing an infrared search-and-track capability on the Golden Eagles, which they do not currently possess, are two examples of how we are improving the legacy birds that will stay with us for a while. With respect to the F–15E model and its radar, its major mission is air-to-ground, and the electronically scanned array radar for that platform will not only permit better targeting of ground targets, but also moving targets, which is a significant advantage with that installation. Senator COCHRAN. Thank you very much. I’d ask, Mr. Chairman, that my additional questions be submitted to the witnesses. Chairman INOUYE. Without objection, so ordered. Senator Bond. Senator BOND. Thank you much, Mr. Chairman. 385

4.5 GENERATION FIGHTER Gentlemen, following my opening comments, I believe we can harness savings by putting more missions, not less, into the cost- effective Air Guard and procuring a blend of fifth-generation and highly capable, more affordable, and proven 4.5 generation fighters. That would ensure our Nation has at least two competing production lines. It’s obvious that the situation has only grown more dire, as evidenced by the Nunn-McCurdy breaches, the Government Account- ability Office (GAO) reports, and the joint estimate team (JET) study findings since you last told me, at this subcommittee, that, ‘‘All options are on the table,’’ to address this shortfall. General Schwartz, with shortfalls growing, and the inordinate delays of the key JSF program, with the cost going from an originally projected $55 million per copy to somewhere between $135 and $150 million, and the situation getting worse, why have you taken the 4.5 generation option off the table as a means of addressing these shortfalls? General SCHWARTZ. Sir, the simple answer is that acquiring a 4.5 generation capability that will last as long, in the force structure, as a generation-5, seems to me—not the most prudent way to approach this problem. We have a limited pool of resources. And it is our sense, sir, that we should not dissipate that limited pool of resources, which we would prefer to devote to generation-5 capability, vice purchasing generation-4.5 that will last just as long. Instead, we believe that it is more prudent to extend the service life of certain elements of our existing fleet at some 10 to 15 percent of the cost of purchasing new, and maintaining our commitment to the F–35; which, as I suggested earlier—we believe will be the backbone of tactical aviation, not just for the Air Force, but for the Navy, Marine Corps, and our international partners as well. Senator BOND. General Schwartz, I’ve heard questions about whether the JSF can even operate off of a carrier. There is a need right now. We have a shortfall right now. You could get, perhaps, three or more 4.5 generations for replacing some of the F–35s you’re waiting to buy, if they ever complete their tests. But, when you talk about service-life extension, I’m not willing to buy the 14th Street Bridge again. The P–3C life-extension program terminated due to excessive costs. Same for the A–63. Same for the F–14A. The SH–60R cost increased from $4 billion to over $12 billion. The UH–1 and the AH–1 cost increased from $2.78 billion to $8.78 billion. And I think it’s far better if you need those 4.5 to need to buy those. Let me address one very urgent question that the Guard has. Ap- proaching the C–130 seems to be done in a vacuum. The Air Force identified the mobility capabilities and requirements study as the reason for reduction in the tactical airlift aircraft. But so—like many other self-fulfilling studies, it ignored the homeland defense mission and the role that the Air—C–130s play as a key element of the strategy. Additionally, the Air Force has admitted the plan was to accelerate the early retirement of E models. My understanding—and please correct me if I’m wrong—is that the Air Force has 45 C–130 386 aircraft at Little Rock, and the Air Force has 15 C–130 that will not have any restriction for over 3 years. Without prior planning, I believe the Air Force could recapitalize the fleet and meet all training needs for the 3 years, without Ba- nana Republic iron-swapping of aircraft for the Air Guard. Mr. Donley, I appreciate your reply to Senator Leahy and me. I believe that any temporary movement of aircraft is unrealistic. Can either of you tell me whether options like conducting the training at Guard C–130 units, where savings could be harnessed and which would take advantage of the experience of the Guard, were considered before making this swap that I have heard from so many people was unwarranted and unjustified? C–130 TRAINING General SCHWARTZ. Sir, perhaps the Secretary will want to capitalize. Let me give you a little background on this. The training—the way the airplanes are distributed in our Air Force is as follows: Those aircraft that will be staying with us—and that is the C–130H model—H2, H2.5, H3s—are predominately—in fact, 77 percent of those aircraft reside in the Air National Guard and the Air Force Reserve. And the thinking was, given that we were going to recapitalize the remainder of the fleet, with the J model over time, that it made sense for the Air National Guard to assume the training mission for that body of our capability—for the H-model capability. Now, I will acknowledge, sir, that we didn’t do as thorough a job as we should have in articulating the rationale for this earlier on. We now have a solution, which the Secretary responded to you on, which makes the Schoolhouse mission at Little Rock Air Force Base an Air National Guard and Air Force Reserve combined mission, something for which, as you suggest, they are very well qualified to perform, and to do it with airplanes from a number of units around the country, on loan. As we recapitalize, we grow the Js and reduce the Hs, so that the need for that Schoolhouse will sub- side over time, and the aircraft will return to their host units. Im- portantly, it will be—largely, because of the way the force is distributed, it is the Air National Guard and Air Force Reserve that will benefit from this approach. So, sir, that is the background on this. Again, I acknowledge that we did not reach out as well as we should have to explain what the logic was to the Adjutants General and others. And we’ll do better in that respect, sir. Mr. DONLEY. I’d just like to reinforce that, in working through the second round of this problem, which we did in the last couple of months, and which I’ve responded to you on in a letter—the Air Force Reserve and the Air National Guard led that work. So, they went through a number of options for how to best accommodate the early retirement of C–130s, to take a stronger role in running the Schoolhouse at Little Rock Air Force Base, and to do that in a way that was, we felt, least disruptive to the individual Air National Guard units. And I believe we worked through a successful conclusion on that. Senator BOND. Thank you. 387

Mr. DONLEY. And we also had the benefit, in that solution, not only retiring the Active Duty C–130s, but being able to reapply the Active Duty manpower to higher priority missions, such as those the chairman mentioned. Senator BOND. Thank you, Mr. Secretary. Thank you, Mr. Chairman. My apologies—— Chairman INOUYE. Senator Dorgan. Senator BOND [continuing]. For going over. Senator DORGAN. Mr. Chairman, thank you. General Schwartz, I noticed that Colonel Keith Zuegel is sitting behind you. And he’s retiring this month, I believe. And I just wanted to say, on behalf of the subcommittee, that he’s, I think, been the chief of your Liaison Office for some long while and, I think, done a great job working with the subcommittee. So, Colonel Zuegel, good luck in your retirement. General SCHWARTZ. He is a great example of the talent that we have in our Air Force, sir. Senator DORGAN. Let me ask you about two things. And I’ll just ask both of them, and then perhaps both of you could respond. One is: you’re going to stand up about 25 more combat air patrol units across the country, for UAVs. And I notice some of them are going to bases that house fighters and bombers. I also notice that is not necessarily the requirement for a combat air patrol unit. Some might think, in a kind of an old-fashioned way, that there has to be a merger. But, we also have combat air patrol units in areas that don’t have fighters and bombers, who do just as well. And, I guess what I would ask—and you know why I’m asking, because we have one—a terrific base, with substantial capability to house additional missions, and that’s the Grand Forks base—that you take a look at—and you probably already do this, but take a look at, how do you minimize the need for Milcon as you place these units? Because you’ve got some capacity, particularly the Grand Forks Air Force Base, as you’re moving tankers out; the opportunity for another combat air patrol unit up in that area, or two, is a great opportunity. So, that’s number one. I understand why some will counsel you, ‘‘Put it near fighters and bombers’’ others will say, ‘‘Completely unnecessary.’’ Second, my colleague from Missouri asked about the Joint Strike Fighter, and all of us who have been so supportive of that are also disappointed, in the sense that—as I calculate it—what we were told—I was on this subcommittee in 2002, and we were told—I guess, 2001—that the estimated cost was going to be $50 million per copy. And the latest estimate—an independent group formed by the Pentagon estimated 80 to 95. Well, taking the midrange of that—this is 2002 dollars, now—that’s about a 75-percent increase in the per-unit cost for a Joint Strike Fighter. I mean, that’s really alarming. Because what happens is, there’s this relentless march in increased costs that is just going to break the back of the Air Force and the Pentagon if we don’t get some handle on it. So, the simple question is: Why? What accounts for a 75-percent projected per-unit cost of the Joint Strike Fighter? Because it was heralded to us as something that was ‘‘Nirvana,’’ it was going to serve over the range of services, ‘‘We’re going to build enough of 388 them to have the per-unit costs substantially down.’’ But, it turns out now, in a very few short years, as we’re just starting to produce, that the cost has just climbed way beyond that which is reasonable. So, the question is: Why? JOINT STRIKE FIGHTER UNIT COSTS Mr. DONLEY. Mainly this is time. It’s a function of time. Senator DORGAN. Well, I’m talking about 2002 dollars, as estimated by the independent group—— Mr. DONLEY. Yes, sir. This means there have been delays, internal to the program, which add years—or months and then years to the projected schedule of the program, which then add years to the end of the program. So, you carry the program further out. Senator DORGAN. And what has caused the delays? Mr. DONLEY. A variety of issues have caused that. We’ve had too many engineering hours, which have not come down as the manufacturer works through the transition from development to production. They have fallen behind in the flight testing, because they haven’t produced the initial jets on the planned schedule. Then they’ve fallen behind on the test program, so we have to work through the production issues. And then we have to slip the test program and add money for development. So, this was the work that was done by the Department over the winter to restructure this program. It was a top-to-bottom scrub. It was really the product of a 2-year effort. When the Chief and I came in, there was already an independent estimate going on on this program. And Secretary Gates made the correct decision to make adjustments in the fiscal year 2010 program, adding money for development—over $400 million, as I recall, just in fiscal year 2010. By the time we got to the end of calendar year 2009, we’d had two rounds of independent estimates, and we stepped up to the fact that the program was not executing as it needed to. And this was, really, the strategic-level decision to restructure the program. Senator DORGAN. Did we miss some early-warning flags here on this subcommittee? Because I don’t remember sitting and listening to the fact that we’re going to—we may end up having a 75-percent increase in per-unit cost for the one—for the Joint Strike Fighter. I mean, is this just laid in our lap all at once? Mr. DONLEY. If I can be bold, here, from a staff-level perspective, I don’t believe there were surprises. The program had challenges and was falling behind in some areas. The issue was whether or not to believe the program office and the contractor, that they had a fix for those shortfalls. And really it was just in the last 2-year period where we had independent eyes on it. We determined we were not going to take a promissory note for a ‘‘get-well plan’’ that was not materializing. So, we decided to make a huge adjustment in the program at that time. Senator DORGAN. Mr. Chairman, could I just—I know my time is expired, could I ask for a 1-minute response on the combat air patrol units in one of the best air bases in America, the Grand Fork Air Force Base? General SCHWARTZ. Senator Dorgan, let me explain two things. 389 First of all, the rationale for co-location with other fighter or bomber combat Air Force units. This is a human-capital question. And the issue is, how do we groom combat leaders that understand both the traditional kinds of capabilities that we’ve fielded for decades, and the new? And how do you integrate remotely piloted and traditionally manned aircraft in the right kind of packages? This is the logic behind, fundamentally, the notion of co-location in some locations. It is not a major point driver in terms of our evaluation of installations. I would argue that the availability of facilities is—on a point basis—a greater consideration. But, the logic was to give some deference to our need to grow airmen commanders who understand all aspects of our portfolio, and can apply them, as required. Senator DORGAN. Mr. Chairman, thank you very much. Chairman INOUYE. Thank you. Senator Murray. Senator MURRAY. Thank you very much, Mr. Chairman. The President’s budget for this year, 2011, doesn’t include any investments in military construction at Fairchild Air Force Base. And I wanted to ask you why. I was just out at the base, Fairchild, in April; had a chance to tour, take a look at all that’s going on there, and talk directly with the base community. And there are a lot of facilities at Fairchild that are in need of upgrades, and some aren’t even sufficient to meet the needs of a 21st century Air Force. Can you explain, Mr. Secretary, why there’s no military construction investment in Fairchild this year? AIR FORCE MILITARY CONSTRUCTION Mr. DONLEY. Very simply, we have chosen to take risk in infrastructure. We have underfunded our military construction and facility infrastructure, for several years running now. And I believe our Air Force budget is—we’ll get you the exact numbers, is less than $2 billion a year at this point. [The information follows:] Our fiscal year 2011 Air Force military construction (Milcon) and facility infrastructure budget is $4.6 billion ($1.5 billion for Milcon and $3.1 billion for facility sustainment, restoration, and modernization). Mr. DONLEY. So, it is at low levels, and has been for several years. As we confront other resource challenges inside the budget, pressures of varying kinds—it just—it costs a whole lot more in the future. Do we have a long-term recapitalization plan for our bases? Mr. DONLEY. Ma’am, I would just say that there’s a difference between military construction and facility maintenance. And we have maintained the Department standard on facility maintenance. Pri- marily, we focus the limited military construction dollars on a new mission. Remotely piloted aircraft is a case in point. And we don’t have, apparently, in this case—and we’ll confirm that—a new mission at Fairchild Air Force Base. Senator MURRAY. Well, let me ask directly about that. In the past, we’ve heard promises that the first KC–X tankers will come to Fairchild. That was walked back. The men and women who serve at Fairchild have a great proven track record with our tankers, and they’re ready and willing to fly the KC–X. Have you yet 390 prioritized which squadrons need to have their aircraft replaced first, based on their maintenance records, Mr. Secretary? KC–X BASING Mr. DONLEY. I’ve not. Let us get you an answer for the record on this specific question. [The information follows:] Senator Murray, as you know, the Air Force now uses the Strategic Basing Proc- ess to make all future basing decisions. The result of this process will not be directly linked to the existing tanker inventory or any future retirements of the KC–135 fleet. Actual basing decisions will be made in an incremental fashion to align with aircraft deliveries, typically 2 years in advance of delivery. Mr. DONLEY. In general, we have not yet had to make the decision on the initial beddowns for KC–X tankers. But, we did include, in the request for proposal (RFP) that is now out and a matter of public record, a representative list of bases that were continental U.S. bases and overseas bases to which tankers could be bedded down. And we did that for the purposes of the evaluation. And Fairchild Air Force Base is included in that list. Senator MURRAY. Right. Well, with respect to the tanker, I wanted to ask you, with bids not due, now, until July 9, this is starting to sound like a fairly compressed bid evaluation timeline for the Air Force. It’s really important that the Air Force has enough time to make a full and fair assessment of the bids that come in, and then that that decision will be held up under scrutiny, as we all know. And I’m very concerned about this discussion of a projected contract start date of November 12, when there’s no projected award date, that I know of, yet. And the entire acquisition process now continues to be hampered by delays. Mr. Secretary, how can the Air Force talk about tentative start dates when they haven’t projected an award date yet, and seem sort of uncertain about when that will be? Mr. DONLEY. Based on our experience in this RFP and previous ones, the judgment was it’s best, at this point, not to exactly try to pin down when the contract award would be, or when the source selection would be completed. We’ll leave that to the source-selection authority. They have, I think, ample time to review the proposals, which are due July 9, 2010. So, we think there are several months for reviews. And there are, I would say, multiple reviews— independent reviews, as well—that need to be factored in. But, we did feel, as a matter of record for the RFP, that it is important to tell the contractors, all offerors, when we think a contract award would be made, so that they have a firm date at which they need to be prepared to proceed. Senator MURRAY. Well, my understanding is, November 12 is the contract start date, not the award date. Mr. DONLEY. Yes. Senator MURRAY. And you have not—— Mr. DONLEY. That’s correct. Senator MURRAY [continuing]. Given them an award date yet. Mr. DONLEY. That’s correct. ‘‘Contract start date’’ was the term. Senator MURRAY. And you believe that that’ll give you enough time? 391

Mr. DONLEY. We believe so. Senator MURRAY. Okay. WORLD TRADE ORGANIZATION RULING IN TANKER COMPETITION I also wanted to ask you about the World Trade Organization (WTO) ruling that Airbus has received illegal trade-distorting subsidies, for years. And, in particular, the World Trade Organization found that the A–330, which is the very airframe that they planned to use in this tanker competition, has been built using illegal subsidies. Now, I continue to be very troubled that DOD is awarding this contract—it’s taxpayer funded, $35 billion competition. Without accounting for the billions of dollars in illegal subsidies that Airbus has received, I want to know how you can assure American taxpayers that they won’t be spending money now to support an illegally subsidized company that one part of our Gov- ernment, the United States Trade Representative (USTR), has already declared harmful to American jobs. Mr. DONLEY. We have, in the Department of Defense, worked through this issue with the U.S. Trade Representative and the—— Senator MURRAY. Have you been personally briefed by the Trade Rep? Mr. DONLEY. We’ve had conversations with the Trade Represent- ative, yes. And the judgment inside the executive branch, not just the Air Force or DOD, but working with our interagency partners, is that it would not be appropriate for the Department of Defense, in a single contract action, to take action representative of a WTO- level decision. Senator MURRAY. If one company is bidding against a company that has been subsidized, our taxpayers are essentially fighting against a country rather than a company. Mr. DONLEY. The WTO has an appeal process, which still needs to play out. There is, as you know, an additional suit in front of the WTO that involves a countersuit. And there are appeal processes that are laid out in WTO procedures. As a Government, we need to follow those appeal processes, which eventually get to the point of making tradeoffs and making determinations on how to affect the results of the appeal process at the end—— Senator MURRAY. Well, I understand the end result of a ruling. But, again, the A–330 is what they said has been illegally subsidized. So, I’m sure we’ll—— Mr. DONLEY. I understand. Senator MURRAY [continuing]. Have more conversations—— Mr. DONLEY. Yes, ma’am. Senator MURRAY [continuing]. About it as we move forward. Thank you very much, Mr. Chairman. Chairman INOUYE. Thank you. Senator Bennett. Senator BENNETT. Thank you very much, Mr. Chairman. And, gentlemen, welcome. Appreciate your good work. And you know what I’m going to talk about, which is the Solid Rocket Booster Program. I believe that this administration has made a very serious mistake in restructuring the National Aero- nautics and Space Administration (NASA). And you say, ‘‘Well, 392 why do we care, in a defense hearing?’’ It’s because it has to do with the industrial base of solid rockets. And regarding the Minuteman, specifically, I’d like to know if the Office of the Secretary of Defense had any conversations with NASA, or the Air Force had any conversations with NASA, before the President announced his intention to shut down solid rocket production? NASA AND SOLID ROCKET PRODUCTION Mr. DONLEY. I’m not aware that the Air Force was consulted specifically on the NASA decisions. Senator BENNETT. Well, you’re deliberately—you’re very definitely affected by this. And do you have any plans to sustain the industry in order to continue to meet current deployed and future anticipated strategic spacelift and tactical missile needs, because you can’t meet those needs with liquid rocket—or liquid-fueled rockets? Mr. DONLEY. We do understand the challenge. And we do not have an answer, at this moment, as to how we intend to proceed. The Air Force has had discussions, at a couple of levels, with the National Reconnaissance Office (NRO) and with NASA officials at the highest levels. I’ve talked to Administrator Bolden and I’ve talked to General Carlson at NRO. We have recognized this as something we need to work together, going forward. We don’t have answers right now, but we have folks that are focused on this challenge. Senator BENNETT. Well, both the chairman and the vice chairman know of my strong interest in this. I’m glad to know you recognize that you have a challenge, independent of what may happen with NASA. And I’m going to be working with Senator Mikulski to see what I can do to see to it that there is a delay in the decision, as far as the President is concerned, because I think we have to solve the question of, How does the Defense Department cover its needs in solid rockets if NASA goes ahead with what I consider to be a very ill-considered decision on the part of the President? Do you see any increased risk if the Minuteman motors—stop the production of Minuteman motors, 19 years short of the planned operational status of that particular missile? Mr. DONLEY. In general, Minuteman has been a very reliable system for us, and it continues to test well. But, we do know that we have challenges ahead with respect to maintaining a warm base. And we’re not satisfied with the bridging solution that we had developed here, over the last couple of years, which takes us through 2011. So, we need to find a way forward for fiscal year 2012 and beyond on this subject. Senator BENNETT. I agree with that, absolutely. And anything you can do to weigh in with the administration— you say you’re talking to the Administrator of NASA, and that’s fine. But, life being what it is, I don’t think that’s where the decision was made. Frankly, I—I won’t put words into his mouth, and I won’t give any suggestion of his intentions, but strictly my own opinion is that—let us say, ‘‘a generic NASA Administrator’’ concerned pri- 393 marily for the survival of his organization would not have approved this. And I think it’s a decision that was made at the Office of Management and Budget (OMB) and dictated to this particular NASA Administrator. So, conversations with the NASA Adminis- trator may not be productive in this area. And I would urge you to have conversations with whatever ‘‘elves’’ within the administration you deal with, over at OMB, because I think that’s where the decision was made—or whoever the masters are. And that the NASA Administrator’s being a good soldier—or good airmen, depending on where he went to college—and carrying out orders. But, this is a very serious kind of question. And I just would close, Mr. Chairman, with this observation. Do you know where the term ‘‘Minuteman’’ came from? It came from the initial rockets that were created in our days, race with Sputnik and afterwards, that were liquid fuel. And to get those things fired up, get them launched, took hours. And suddenly we had a ‘‘Min- uteman’’ that could be fired within minutes, because it had a solid rocket motor, rather than a liquid rocket motor, and could go immediately. And now, we’re in the process of eliminating our industrial base of solid rocket motors. And you may not have any Minuteman left over if we go back, by virtue of the decision at NASA, to an industrial base that is given entirely to liquid rocket motors. I’ve made my speech. Thank you, Mr. Chairman. I appreciate your indulgence. Chairman INOUYE. Thank you very much. Senator Brownback. Senator BROWNBACK. Thank you very much, Mr. Chairman. I’m glad to hear that history about Minuteman. I didn’t know that piece. I wanted to go back to ‘‘Day-man,’’ I guess, on this—— Senator BENNETT. Six-hour-man. Senator BROWNBACK. Six-hour-man. Secretary, I want to follow up with what Senator Murray had asked. This is obviously a major issue for my State and the tanker contract. And I’ve been frustrated about the lack of being able to consider the illegal subsidy. And we’ve had many discussions about this, you know, with Secretary Murray—or with Senator Murray. For the military, if every step of appeal were exhausted, and the World Trade Organization found that Airbus had illegally subsidized the A–330 that they had bid, and this was conclusive, and all the appeals are done, would you consider that in the bid—the base bid of the contract?

WORLD TRADE ORGANIZATION RULING IN TANKER COMPETITION

Mr. DONLEY. I wouldn’t commit to that at this point, because I think our answer would be, we would be working with the U.S. Trade Representative, and he would be working—he or she would be working through that WTO process to arrive at the appropriate specific steps to be taken at the end of that process. And this is why the internal judgment to the administration is that it would premature to take any particular action, at this point, on this program. 394

Senator BROWNBACK. Doesn’t that invite other countries to do very similar actions to get our military contracts, whether it be ships or virtually anything of a military contract? Mr. DONLEY. I wouldn’t speculate on what motivations might be from other companies to do this. I would simply say and I don’t know that this would completely satisfy your concern but, both of the offerors involved here are international companies. We need to think through very carefully, as a nation, how we operate in the WTO and in the international marketplace, with respect to imports and exports, and goods and services provided. At the same time there are concerns about bringing onshore competitors to U.S. industrial-base partners. We also have to recognize that our international companies here in the United States want to sell abroad—— Senator BROWNBACK. Well, I—— Mr. DONLEY [continuing]. And we have to have doors open for that as well, as do—— Senator BROWNBACK. And can be sued under the WTO, as well, abroad. But, I—it seems like, to me, if you’re a foreign country, and you’re reading the tea leaves on this, and we—frankly, I think we’ve bent over backwards to try to get Airbus to bid on this. And we’ve held it open extra length of time. And certainly citizens in my State are livid about what the military is doing to try to give this to Airbus, with the—you know, with the extra—holding it open a longer period of time, do all these steps. But, at least on this illegal-subsidy piece, if we don’t fix that hole, I would think other countries would say, ‘‘You know, the United States builds ships. Why don’t we subsidize our way into shipbuilding. Well, let’s get some of these contracts. These are great contracts. Why don’t we do’’—there’s just a whole series of ones, to the point that I think we should put, in statutory form, that if there is a subsidy, as determined by WTO, that that’s considered into the base price of the bid. Whether it’s a U.S. company or a foreign company that does something like that—and I’m particularly targeted at foreign companies—but, to give us some teeth and to make some clarity on a major issue that I think you’re inviting more foreign companies, or others, to figure ways to subsidize to get major U.S. military contracts. And I think we’d be wise to just put that in statutory form. Mr. DONLEY. Without responding directly to that proposal, I would just offer that in the context of the KC–X RFP, our approach to this is to hold the U.S. taxpayers harmless from any penalties that might be assessed on one manufacturer or another as we go through this WTO process. So, if there are penalties somewhere along the line, that we do not pay for those in the KC–X program. General SCHWARTZ. And, Senator, if I may, just to clarify, there was no change in the requirements for the platform. The decision to extend was, in my view, largely in the interest of a competitive scenario. But, I can assure you, there was no change in the requirements. Senator BROWNBACK. Well, if you award this to Airbus, after this step—extraordinary step of extending the time period—and it’s a $35 billion contract, and it’s a subsidized platform, which we all know is a subsidized platform—I think you’re going to have some 395 very irritated people in the United States of America. So, I would hope that wouldn’t be the case. And I hope we can give you some statutory clarity on figuring the subsidy price into these military contracts. Thank you, Chairman. Chairman INOUYE. I thank you very much. ADDITIONAL COMMITTEE QUESTIONS Because of the conflict that’s on our Senate schedule, several members have not been able to attend. And they have questions; they’ve asked me to submit them to you. And it should be obvious that all of us have other questions to ask. So, without objection, I will be submitting to you, Mr. Secretary and General, questions for your responses. And in behalf of the subcommittee, I thank you for your testimony this morning. And we want to thank you and the men and women in your command for their service to our Nation. [The following questions were not asked at the hearing, but were submitted to the Department for response subsequent to the hearing:]

QUESTIONS SUBMITTED TO HON. MICHAEL B. DONLEY

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE Question. Secretary Donley, to meet emerging requirements, the Air Force is quickly expanding its unmanned aerial vehicle and cybersecurity missions. It is adding thousands of highly trained personnel to these career fields in a short time. How is the Air Force managing the manpower challenges associated with these new missions? Answer. The Air Force has programmed actions to source the manpower required to grow its remotely piloted aircraft fleet operational capability to 50 combat air patrols (CAPs) by fiscal year 2011, with existing manpower identified in the fiscal year 2011 President’s budget request. We are also in the process of identifying existing, lower-priority manpower authorizations for realignment to the 65 CAP requirements by 2013 as part of our fiscal year 2012 budget submission. Specific intelligence, surveillance, and reconnaissance career field impacts are under study. In order to develop and institutionalize cyberspace capabilities and to better integrate them into the Joint cyberspace structure, the Air Force funded manpower in the fiscal year 2010 President’s budget to establish a Cyber Numbered Air Force (24 Air Force). Furthermore, the fiscal year 2011 budget request reflects a continued Air Force commitment to cyber superiority as we sourced manpower for fiscal year 2011 to support enhanced Network Attack capabilities. Question. Secretary Donley, what do you see as the role of the Air National Guard and Air Force Reserve in UAV and cybersecurity operations? Is the high operational tempo of these mission sets compatible with the civilian responsibilities of our Guardsmen and Reservists? Answer. Both the Air National Guard (ANG) and Air Force Reserve play significant roles in our ongoing overseas contingency operations providing critical support to our Joint Force Commanders. With respect to remotely piloted aircraft (RPA) operations, the ANG has four MQ– 1 Predator squadrons providing two combat air patrols each and one MQ–9 Reaper squadron providing one combat air patrol in the U.S. Central Command theater of operations. Although each ANG unit was programmed to provide only a single combat air patrol (CAP), as a result of the increasing demand for this capability, each MQ–1 unit was mobilized in 2008 to provide an additional CAP. As of July 2009, the mobilization expired; however, the ANG voluntarily elected to maintain their additional CAPs allowing the active component to focus its efforts elsewhere, such as increasing RPA training capacity. In addition to the combat support each unit is providing, some units are providing RPA maintenance and flying training capability. The California ANG stood up a maintenance training unit in 2008, graduating approximately 600 Active, Guard and Reserve students each year and a flying training unit in 2009, producing ap- 396 proximately 40 Active, Guard and Reserve RPA aircrews (pilots and sensor opera- tors) each year. The New York ANG provides maintenance training for the MQ–9, while the Nevada ANG provides both combat and flying training support by augmenting RPA personnel at Creech Air Force Base, Nevada. As we continue to expand our RPA efforts, we anticipate increased ANG participation within the next few years at 4–6 additional locations. The Air Force Reserve is supporting warfighter efforts with an Air Force Special Operations Command MQ–1 squadron at Nellis Air Force Base, Nevada, and we will be standing up an RQ–4 Global Hawk Reserve squadron at Grand Forks Air Force Base, North Dakota. We are also examining different possibilities for expanding Reserve participation in the MQ–1 and MQ–9 communities as we continue to our planned growth to 65 MQ–1/9 CAPs by the end of fiscal year 2013. With respect to cyber security operations, eight Air National Guard units currently provide cyber capabilities that meet combatant commander and Air Force requirements. For example, the 262nd Network Warfare Squadron of the Washington ANG provides vulnerability assessments of Air Force networks to bolster security and prevent attacks. Additionally, Air Force Reserve personnel augment several active duty cyber units, working in the same duty positions as their active duty counterparts. Question. Is the high operational tempo of these mission sets compatible with the civilian responsibilities of our Guardsmen and Reservists? Answer. Yes. For RPAs, aside from takeoff and landing, the Air Force operates our MQ–1/9 and RQ–4 aircraft via satellite data link from stateside locations. This capability has significantly reduced the number of personnel needed to deploy, lessening the impact on our Guard and Reserve forces. While the operations tempo remains high, a majority of our Guard and Reserve support has come from volunteerism. When the ANG’s mobilization expired in July 2008, each of our ANG MQ–1 squadrons requested to maintain their surge CAP in addition to the single CAP they were programmed to provide. Additionally, despite being at war, our Guard and Reserve units conducting RPA operations have been able to maintain their civil support commitments during other contingency operations such as floods, fires and earthquakes. For the cyber security mission, steady-state support to the Air Force, as well as mobilizations—whether voluntary or involuntary—have historically not resulted in adverse impacts to ANG personnel or their ability to meet obligations to civilian employers. In addition, Guardsmen and Reservists are often employed by some of the most high-tech companies in America such as Cisco, EDS, Microsoft, Siemens and Symantec who also engage in cybersecurity of the nation’s infrastructure. Both the military and civilian sectors benefit by having these professionals work in both environments. Question. Secretary Donley, Lieutenant General Wyatt, the Director of the Air Na- tional Guard alerted us to the fact that 80 percent of its F–16 fighters begin reaching the end of their service life in 7 years. Retiring these aircraft will almost eliminate the Air National Guard fleet dedicated to the Combat Aviation and Air Sov- ereignty Alert missions. With delays in the F–35 program now documented, it appears that the Air Force is taking some risk in the size of the fighter inventory. How will you ensure that enough aircraft are available for the important homeland security mission? Answer. Defense of the homeland is the DOD’s highest priority mission. The Air Force will continue to steadfastly support Operation Noble Eagle (ONE) through the Total Force concept as it has since 9/11. ONE requirements are currently driven by the April 2009 CJCS Execute Order (EXORD) and May 2009, U.S. Pacific Command EXORD, and are sourced through provisions of the Secretary of Defense approved Global Force Management process. While ONE is a Joint mission, the Air Force has historically performed the overwhelming majority of ONE fighter missions. The Air Force has sufficient fighter inventories to execute ONE based on the current requirements. Question. Secretary Donley, is the Air Force looking at new missions for the Air National Guard? Are additional association relationships with active Air Force units planned? Answer. We continually examine our force structure needs to fill new or emerging missions with the best Total Force solutions. The Air National Guard is contributing to RPA, cyber, space and other key mission areas. Our desired end state is a leaner, more capable and more efficient Air Force leveraging the strengths of both our active and reserve components, and we will continue to look to implement associate units when the business case and operational requirements support it. Question. Secretary Donley, there is $325 million in the fiscal year 2011 budget request for the NPOESS (‘‘EN-PO¯ SE’’) weather satellite program. As you know, the 397

White House ended the program this fiscal year. What is your plan for the follow- on satellite program and the fiscal year 2011 funds? Answer. The Department of Defense (DOD) stakeholders are in the final stages of determining how best to proceed to meet DOD needs and requirements for this mission using the $325 million in research, development, testing, and evaluation funding in fiscal year 2011. The DOD restructure options are still being studied, however the budgets for the various options conform reasonably well to that of the Future Years Defense Program profile. The DOD is building acquisition timelines, conducting follow-on program risk assessments, assessing industrial base impacts, and determining the level of fiscal year 2011 funding required, in consultation with the National Oceanic and Atmospheric Administration and the National Aeronautics and Space Administration. The DOD expects to provide a more detailed strategy by late-summer this year. Question. Last fall, the Air Force stood up the Global Strike Command, bringing the Air Force’s intercontinental ballistic missiles and nuclear-capable bombers under one command for the first time since the days of the Strategic Air Command. This is the culminating event on the Nuclear Roadmap created to revitalize the nuclear enterprise. Secretary Donley, could you bring us up-to-date on the status of that initiative and tell us what is next? Answer. Air Force Global Strike Command (AFGSC) is on schedule to achieve full operational capability by September 30, 2010. The command assumed the ICBM mission from Air Force Space Command on December 1, 2009 and the B–52/B–2 bomber mission from Air Combat Command on February 1, 2010. AFGSC has developed new command guidance/policies; is actively engaged in the no-notice/limited- notice nuclear surety inspection process, is an active participant in U.S. Strategic Command exercises; and is aggressively working to fill all manpower vacancies, particularly in the civilian workforce. Going forward, command priorities include implementing the provisions of the Nuclear Posture Review, ensuring long-term sustainment of the aging ICBM fleet, and reviewing implications and anticipated enforcement of the New Start Treaty when it is ratified. Question. Secretary Donley, the budget requests $66 million for a new program procuring 15 Light Mobility Aircraft. This new initiative expands your mission which, given the emphasis by Secretary Gates on reducing defense expenditures, appears unusual. Could you elaborate on the benefits of this program and why it is a wise investment now? Answer. LiMA will enable the United States to demonstrate, train and perform lower-cost airlift operations to and from austere areas, working in concert with Part- ner Nations (PN) with limited capacity and capability to perform aviation functions. Primary benefits from this approach include reduced wear and tear on larger, more expensive U.S. mobility aircraft, increased airlift capability in austere regions with sparse infrastructure, and a right-tech aircraft that represents the types of capabilities a PN can afford to acquire, maintain and operate. The result of this approach is the United States will demonstrate the utility of LiMA to a PN, thus facilitating Theater Strategic and Campaign Plan objectives and enhancing our long term capabilities through security cooperation.

QUESTION SUBMITTED BY SENATOR PATRICK J. LEAHY Question. Air Force leadership has come out on the record opposing the F136 alternate engine program for the Joint Strike Fighter. Two aspects of sole-sourcing the F–35 engine are troubling, and DOD leaders have not addressed them yet. First, the F135 engine has never competed against the F136 engine, and under the current DOD plan, it never will. While the prime contract for the F–35 was fully and fairly competed, the sub-contract for the engine was selected as an element of the prime without any competition. Competition would determine which engine is technically superior and it would drive down costs, which is something this program desperately needs. Second, the F–35 will eventually comprise 95 percent of our strike aircraft fleet. If that doesn’t qualify as a need for a redundant second engine, then what does? What happens to our operational flexibility if the fleet is grounded for engine problems? Such occurrences have happened before, such as with the Harrier jet. But never before have we had a grounding of such a broad multi-service, multinational program. Is now really the time to accept that kind of risk? Wouldn’t the Air Force agree that this issue is not just a matter of trading up-front costs for future savings, but also a matter of operational risk and effectiveness? 398

Answer. The Air Force supports Secretary Gates’ conclusion to not pursue a second engine. Maintaining two engine suppliers will result in increased development, production, and support costs in the near term. The Department of Defense (DOD) consistently emphasizes its opposition to a second engine for the Joint Strike Fight- er because continued funding of the F136 would divert funds from other important defense needs. In the middle of two wars, the DOD has higher priority uses for the $2.9 billion that would be required to take the F136 to full competition. Further- more, there is no guarantee that having two engines will create enough long-term savings to outweigh the significant near-term investment. The Air Force does not consider a single source engine for the F–35 to be an unacceptable increase in operational risk. The DOD currently maintains two tactical aircraft programs, the F– 22A and the F–18, each of which utilize a single source engine provider. Both programs have solid safety records, and the DOD is satisfied with the engines for both programs. Over the years, significant advancements in engine design, testing, production, and sustaining engineering have enabled the DOD to manage the risks associated with single engine systems without having to ground an entire fleet. We believe any benefits that might accrue from continued funding of the F136 extra engine would be more than offset by excess cost, complexity and risk. A single source engine for the F–35 provides the best balance of cost and risk for the DOD’s needs in the current resource-constrained environment.

QUESTIONS SUBMITTED BY SENATOR HERB KOHL Question. The USAF has developed a process for quantitative and qualitative analysis to determine the best bed down locations for future F–35 acquisitions. This process has been referred to as transparent, repeatable, and defendable. What is the process for appeal if a unit believes the score is inaccurate? Answer. As part of the process, major command staffs responded to the data call from the lead major command using data sources maintained by each installation. This data was used to create a rank-order list of bases. Military judgment was then applied to identify a smaller candidate base list. Typically a unit is unaware of scores derived during the basing process since this occurs at the Headquarters Air Force and this information is not shared with installation commanders. If a unit believes the data used and resultant scores are inaccurate, they can appeal through their major command to then be resolved at the Headquarters Air Force level. Question. Why, if this is a transparent process, is the USAF withholding the scores from public scrutiny? Answer. The Air Force Air Force policy throughout the basing process has been to provide the Members of Congress the scores for installations within their state as well as a relative ranking of each installation within the top, middle, or bottom third of the scoring range. Installation scores were used to create a rank-order list of bases. Military judgment was then applied to identify a smaller candidate base list. This candidate list was released to Congress on October 29, 2009, and briefings have been provided to congressional members and their staff when necessary to explain how the scores were derived without revealing the scores of other installations. Question. What role did the nations Adjutants General have in this process? Answer. The Air Force strategic basing process does not include direct participation of the Adjutants General. Participative and representational roles are reserved for the major commands, which in this case, includes the Air National Guard and Headquarters Air Force. Base specific information was obtained from major commands and unit records, screened by the major command and eventually incorporated into analysis by Air Combat Command, the lead major command for F–35A basing. The information was then brought to Headquarters Air Force senior leaders through the Strategic Basing-Executive Steering Group for consideration. Question. Were the Adjutants General given an opportunity to comment on quantitative scores before the USAF leadership applied qualitative analysis? Answer. No. The Air Force strategic basing process does not include the direct participation of the Adjutants General. Participative and representational roles are reserved for the major commands, which in this case includes the Air National Guard and Headquarters Air Force. The Director of the Air National Guard is fully integrated in the basing process and in constant communication with the Adjutants General. Base specific information was obtained from major commands and unit records, screened by the major command and eventually incorporated into analysis by Air Combat Command, the lead major command for F–35A basing. The informa- 399 tion was then brought to Headquarters Air Force senior leaders for their consideration. Question. What role did the Director, Air National Guard (DANG) have in the qualitative analysis? Answer. Air National Guard representatives from the National Guard Bureau and the Air Staff participated in the deliberations of the Basing Request Review Panel, the first step in the Air Force Strategic Basing Process. The Deputy Director, Air National Guard participated in the Strategic Basing-Executive Steering Group as it formulated options for Chief of Staff and my discussion, review and decision. The Director, Air National Guard or his representative participated in discussions with us to a final decision regarding which bases were identified as training and operations candidate bases. Question. Given that he is likely in the best position to know the Air National Guard units and locations, was the DANG provided an opportunity to shape or influence the USAF leadership’s best judgment? Answer. Yes. The Deputy Director, Air National Guard participated in the Stra- tegic Basing-Executive Steering Group as it formulated options for the Secretary and the Chief of Staff discussion, review and decision. The Director, Air National Guard also participated in discussions with the Chief of Staff and me prior to a final decision regarding initial basing locations for the F–35. Question. The Wisconsin National Guard submitted a detailed analysis of the score for the 115th FW, Madison, Wisconsin, which outlines factual errors. This analysis was delayed as the Wisconsin National Guard was unable to obtain its score from the USAF through the NGB. Why did the USAF insist that the NG obtain base scores only through congressional delegations? Answer. Air Force policy throughout the basing process has been to provide only the Members of Congress the scores for installations within their state as well as a relative ranking of each installation within the top, middle, or bottom third of the scoring range. Base specific information was obtained from major command and unit records, screened by the major command and eventually incorporated into analysis by Air Combat Command, the lead major command for F–35A basing, then brought to the Pentagon for consideration by Headquarters Air Force senior leaders. Typi- cally a unit is unaware of scores derived during the basing process since this occurs at Headquarters Air Force and this information is not shared with installation commanders (Active, Guard or Reserve). Briefings have been provided to congressional members and their staff when necessary to explain how the scores were derived without revealing the scores of other installations. Question. The WI NG requested correction in five areas amounting to nine points. To date, there has been no resolution—what is the current status? Answer. Although agreement was reached to revise the quantitative score, the score change was not enough to significantly affect the 115th Fighter Wing’s relative standing. The Air superiority alert mission was considered in the qualitative assessment as positive, but was not a driving factor that eliminated any one base as a candidate location. Question. The WI NG points out that the base score did not correctly identify the 115th FW as an ASA home alert location—a criteria identified by the USAF as pro- bative in the qualitative analysis. If the quantitative score is inaccurate and qualitative indicators are not identified, how can the USAF be sure that this unit was fairly assessed? Answer. Although agreement was reached to revise the quantitative score, the score change was not enough to significantly affect the 115th Fighter Wing’s relative standing. The Air superiority alert mission was considered in the qualitative assessment as positive, but was not a driving factor that eliminated any one base as a candidate location. Question. How did ASA alert affect the final determination for future F–35 bed down locations? Answer. The air superiority alert mission was considered in the qualitative assessment as positive, but it was not a driving factor that eliminated any one base as a candidate location. Question. What were the qualitative scores for the other bases in the top third? We specifically request the full scoring sheets for comparative analysis. Answer. Air Force policy throughout the basing process has been to provide only the Members of Congress the scores for installations within their state as well as a relative ranking of each installation within the top, middle, or bottom third of the scoring range. Base specific information was obtained from major command and unit records, screened by the major command and eventually incorporated into analysis by Air Combat Command, the lead major command for F–35A basing, then brought 400 to the Pentagon for consideration by Headquarters Air Force senior leaders. Typi- cally a unit is unaware of scores derived during the basing process since this occurs at Headquarters Air Force and this information is not shared with installation commanders (Active, Guard or Reserve). Briefings have been provided to congressional members and their staff when necessary to explain how the scores were derived without revealing the scores of other installations. Question. Assuming that the USAF leadership moved some lower scoring units above units with higher scores in the basing decision, what was the justification for this best military judgment? Answer. Lower scoring units (installations) were not moved above higher scoring installations. The Air Force produced a rank ordered list of installations using quan- tifiable criteria. Beginning with the top-ranked installation, the Air Force reviewed each in rank order, applying military judgment to identify candidates that could meet mission requirements. An installation could be eliminated from consideration as a result of military judgment. There were three possible outcomes after military judgment factors were considered. These outcomes were: Yes—an installation is a candidate within timing window; not yet—an installation is not a candidate within timing window; no—an installation is currently incompatible with requirements. As an example, military judgment factors were developed to assist uniquely qualified and experienced senior Air Force leaders in identifying candidate installations for basing F–35A aircraft programmed for delivery through the fiscal year 2017 timeframe. These factors included: Plans and Guidance; Global Posture; Building Partnerships; Total Force; Beddown Timing; Force Structure; Training Require- ments and Efficiencies; Logistics Supportability; and Resources/Budgeting.

QUESTIONS SUBMITTED BY SENATOR KAY BAILEY HUTCHISON

MAINTENANCE IN THE AIR FORCE Question. For many of its logistics and sustainment functions including activities such as supply chain management, product support integration, and maintenance, repair and overhaul activities the Department of Defense can select from private sector contractors a well as organic public depot facilities. Please provide to the Committee a description of the methodology employed by the Air Force in making cost comparisons between organic public sector facilities and private sector contractor providers for the purpose of workload assignment for the provision of logistics and sustainment function including but not limited to supply chain management, product support integration, and maintenance, repair and overhaul work. In particular, please explain to the Committee what accounting systems and principles the Air Force uses to ensure full cost accounting for both public and private sector entities in making decisions regarding the assignment of this logistics and sustainment related work. Answer. The methodology employed by the Air Force in making cost comparisons between organic public sector facilities and private sector contractor providers resides as a subset of the overall decisionmaking tool codified in Air Force Instruction 65–509 Business Case Analysis, and Air Force Manual 65–510 Business Case Anal- ysis Procedures. The business case method prescribed in these regulations provides a credible, defendable, repeatable and transparent process by which decision makers are supported with documented, objective analysis. The Air Force has a Source of Repair Assignment Process that includes a review of statutory compliance and requires best value analysis. The first consideration for workload assignment is whether the workload is required to be organic for purposes of meeting 10 U.S.C. 2464, the statute which directs workload into an organic facility for purposes of meeting Core maintenance capability requirements, and/or 10 U.S.C. 2466, the statute requiring that no more than 50 percent of total funding allocated to depot maintenance be performed in the private sector. After an assessment that the workload is not required to meet either of these statutes, we then perform best value assessment. There are three fundamental factors in this best value assessment that are used for the basis of evaluation and eventual decision between organic and contract. These factors are costs, benefits, and risks, each supplying its own specific subset of criteria and variables for analysis and decisionmaking. For accounting, the Air Force annually publishes standard composite rates in Air Force Instruction 65–503 including pay and benefits for military and civilian personnel. The Air Force directs these rates be used when preparing business case analyses. Additionally, there are other overhead costs categories being added to 401 these rates per Directive-Type Memorandum 09–007, ‘‘Estimating and Comparing the Full Costs of Civilian and Military Manpower and Contract Support’’.

F–35 AIRCRAFT FOR LACKLAND AFB, TEXAS Question. Please explain the Air Force’s F–35 stationing plan to the Committee. In particular, please address any plans to station F–35 aircraft at Lackland AFB, Texas. Answer. The Air Force is using a repeatable, transparent Strategic Basing Process to identify locations for the F–35. Air Combat Command, as the lead major command, developed basing criteria which were approved by Secretary and the Chief of Staff of the Air Force and released to Congress in September 2009. These criteria were applied to determine candidate base lists for the initial increments of F–35 training and operational bases which were provided to Congress in October 2009. The environmental impact analysis process is now underway and we anticipate releasing preferred basing alternatives in August 2010, with a Record of Decision announced by spring 2011. Lackland AFB, Texas is not one of the candidate bases being considered for this round of F–35 basing decisions, but will be considered in future rounds of F–35 basing.

NEWER AIRCRAFT FOR TEXAS AIR NATIONAL GUARD Question. Please explain the Air Force’s plan to replace the Texas Air National Guard’s aging F–16 aircraft with newer airplanes at some point in the future. Answer. The Air Force currently has no plans to replace or retire the Texas Air National Guard F–16 Block 30 aircraft within the current Future Years Defense Program.

LONG RANGE PERSISTENT STRIKE DEVELOPMENT PROGRAM Question. Please explain the long range strike capability that the Air Force seeks to develop within its Long Range Persistent Strike Development Program? Answer. During the 2010 Quadrennial Defense Review, a Secretary of Defense- directed tiger team was established to complete an in-depth study of long-range strike—including the long range strike platform (LRSP) need, requirement, and technology. The team’s conclusions were supportive of pursuing a new LRSP platform, but identified the need for additional analysis to explore options for reducing costs and accelerating fielding timelines. Based upon the need for additional analysis, the Secretary of Defense chartered a subsequent study to examine a broader array of long-range strike issues and options including the appropriate mix of long range strike capabilities; upgrades to legacy bombers; manned and unmanned force structure numbers; stand-off and penetrating platform ratios; stand-off cruise missile requirements; intelligence, surveillance, and reconnaissance demands; airborne electronic attack requirements; and conventional prompt global strike needs. The study results are expected to be available in the fall of 2010. Although the specific LRSP performance requirements are still being developed, a general description of the desired attributes includes: —Range and survivability to overcome adversary anti-access strategies and persistence in denied area environments; —Flexible, mixed payloads to engage mobile and hard targets; and —Visible deterrence capability across the spectrum of conflict. We continue our work with the Office of the Secretary of Defense and the combatant commanders to define the requirements for long range strike and to help determine the composition of the long range strike family of systems that will best meet our Nation’s needs for this critical and enduring mission.

QUESTIONS SUBMITTED BY SENATOR ROBERT F. BENNETT Question. Considering the issue of balance, in your discussion of ‘‘Global Precision Attack,’’ you briefly mention the DOD’s plans to assess conventional prompt global strike prototypes which were referenced in the 2010 QDR. However, given the recent recession, the market for small turbofan engines has markedly declined, calling into question the long term affordability based on decreased industrial capacity. In the context of your long-range strike capabilities, what is your estimation of the significance of the role global strike platforms could play? Can you discuss what steps could/should be taken to prepare the way for prompt global strike initiatives in relation to this technology? Answer. Global precision strike capabilities leverage the inherent range, flexibility, and lethality of airpower to hold targets at risk around the globe. To ensure 402 their continued viability, we will continue to work toward a ‘‘family of systems’’ that provides the necessary flexibility and agility. Non-nuclear prompt global strike is a unique capability that could be used against a specific set of targets in limited numbers. It is not intended to be a substitute for other long range strike capabilities but rather to complement them as one component in the long range strike family of systems. The 2010 Nuclear Posture Review highlighted the importance of developing non-nuclear prompt global strike capabilities that could prove valuable in de- feating time-sensitive threats. The Department of Defense is currently studying the appropriate mix of long-range strike capabilities, including non-nuclear prompt global strike. This follow-on analysis will build upon the capabilities identified in the 2010 Quadrennial Defense Review and Nuclear Posture Review allowing the Air Force to make specific recommendations in the fiscal year 2012 President’s budget request. The Office of the Secretary of Defense is managing a defense-wide account, which includes Air Force, Army, Navy and DARPA projects, aimed at developing a Prompt Global Strike capability based on hypersonic technology. DARPA’s hypersonic technology vehicle is an unmanned, rocket launched, maneuverable hypersonic air vehicle with no onboard propulsion system. Its propulsion is provided by the launch vehicle, a Minotaur IV Lite. The Conventional Strike Missile is an Air Force’s concept for Prompt Global Strike based on DARPA technology development. This concept currently involves a strategic sized solid rocket booster to allow for a global range capability. The small turbofan engine was not a candidate in the Conventional Prompt Global Strike analysis of alternatives and is not likely to participate in future discussions due to mission range requirements. Question. At the present time, only two U.S. companies (ATK and Aerojet) produce solid rocket motors for all of our nation’s needs, and only one company (American Pacific) manufactures their most key ingredient. These three companies support all strategic missiles, missile defense programs, military and commercial space lift capabilities, NASA human spaceflight systems, and the entire cadre of tactical missiles available to today’s war fighter. However, demand for products made by the solid rocket motor industry has been in steady decline for many years, and is right now experiencing a further dramatic drop with the completion of the Min- uteman III Propulsion Replacement Program (PRP), the retirement of the Space Shuttle, the termination of the Kinetic Energy Interceptor (KEI), the production slowdown of Ground-based Midcourse Defense (GMD) interceptors, and the Missile Defense Agency’s planned transition from a proven solid rocket motor-based systems to an unproven liquid propulsion-based system. I also understand that prices across weapons systems that are designed around the advantages that solid rocket fuel offers—especially the capability to have fuel loads that will respond instantly to a launch command—will increase given the current course. What plans has the Air Force made to sustain this industry, in order to continue to meet current deployed and future anticipated strategic, space lift, and tactical missile needs? Has the Air Force considered the pending price impact on your widely deployed tactical systems? Do you know if the other services are aware of this approaching issue? Answer. The Air Force leverages research and development projects, joint and individual production programs, and the focused efforts of program managers to assist in supporting key elements of the aerospace industrial base needed to respond to the current and emerging global environment. For example, with respect to the industrial base for solid rocket motors, the fiscal year 2010 President’s budget request calls for the production of nearly 700 air-to-air tactical missiles. These are joint programs supporting the Air Force and the Navy. In the case of large (greater than a 40-inch diameter) solid rocket motors, the Air Force has been closely monitoring this segment of the solid rocket motor industrial base for a number of years. This year, the Air Force initiated a phased study and analysis to develop a risk-based investment strategy focused on sustaining the Min- uteman III system through 2030. Further, an interagency task force, including representation from the Department of Defense (the Office of the Secretary of Defense, Army, Navy, Air Force, and Missile Defense Agency) and the National Aeronautics and Space Administration, will offer solid rocket motor industrial base sustainment recommendations to the Secretary of Defense for a subsequent report to Congress. At this time there is no impact to deployed tactical Air-to-Air or Air-to-Ground Missiles. Yes, other Services are aware. An interagency task force, that includes representation from the Department of Defense (the Office of the Secretary of Defense, Army, Navy, Air Force and Missile Defense Agency) and the National Aeronautics and Space Administration, has been formed to assess the solid rocket motor indus- 403 trial base and provide recommendations to the Secretary of Defense for a subsequent report to Congress. Question. Air Force officials have testified before Congress about the potential concern that prices for the propulsion systems for the Evolved Expendable Launch Vehicle (EELV) might double in price. How does the Air Force plan on managing a 200 percent price increase to the EELV program and what impact will that have on our ability to meet our strategic space requirements? Answer. The Air Force will continue to fund EELV to meet assured access to space and National Space Transportation Policy requirements. The exact increases to EELV launch vehicle costs are not yet known. The Air Force has developed preliminary estimates that incorporate increasing subcontractor costs. The significant reduction in demand within the spacecraft industry has caused subcontractors to rely on the EELV program as their primary customer. As a result, EELV bears the burden for much of these key suppliers’ overhead costs In response to these estimates, the Commander, Air Force Space Command and the Director, National Reconnaissance Office chartered a tiger team to recommend a revised way ahead for the EELV program. Among the items the tiger team is evaluating is a more flexible and transparent contract structure that increases program and industry stability. In addition, collaboration is ongoing with the Department of Defense, the Office of the Director, National Intelligence, the Air Force, and the National Aeronautics and Space Administration to explore synergistic community solutions where possible. Question. In fiscal year 2009, with much support from this committee, the Air Force initiated a Minuteman solid rocket motor warm line program, with production continuing in fiscal year 2010 and fiscal year 2011. However, the future years defense program (FYDP) provided this year shows close out of this warm line effort in fiscal year 2012. While the Minuteman III system is now expected to be deployed through 2030, its solid rocket motors—produced in the early 2000s—were only designed to last 20 years, and actually have a maximum demonstrated life of only 17 years. There is no way to avoid the fact that the Minuteman solid rocket motors will need to be replaced prior to 2030. The Air Force has requested approximately $43 million in fiscal year 2011 for ICBM procurement. However, it is my understanding that the funding will only purchase three solid rocket motor sets, but six are needed to maintain proper certification to build such systems. How does the Air Force plan to sustain the industrial base during the time until any next generation system begins development? If this program is to be closed out in fiscal year 2012, how does the Air Force plan to sustain the Minuteman system’s readiness through 2030? Answer. The Air Force is currently reevaluating the overall Minuteman (MM) III Solid Rocket Motor (SRM) Warm Line concept in order to help sustain the strategic SRM industrial base. If the current MM III SRM production capability is allowed to lapse, any requirement for follow-on MM III SRM production would include the time and costs required to reinstate such a capability. The Air Force, in coordination with industry, has determined what those costs and timelines would be and would include these factors in long-range planning efforts. This year, the Air Force initiated a phased study and analysis to develop a risk-based investment strategy focused on sustaining the MM III system through 2030. Further, an interagency task force, including representation from the Department of Defense (the Office of the Secretary of Defense, Army, Navy, Air Force, and Missile Defense Agency) and the National Aeronautics and Space Administration, will offer solid rocket motor industrial base sustainment recommendations to the Secretary of Defense for a subsequent report to Congress. In 2009 the Air Force completed the Minuteman III Propulsion Replacement Pro- gram designed to extend the life of the weapon system to 2020. The Air Force is evaluating options to ensure solid rocket motor reliability and supportability to 2030 in conjunction with its evaluation of the Minuteman III Solid Rocket Motor (SRM) Warm Line concept in relation to sustaining the strategic SRM industrial base. If the current Minuteman III SRM production capability is allowed to lapse, any requirement for follow-on production would include the time and costs required to reinstate that capability. The Air Force, in coordination with industry, has determined these costs and timelines and will include these factors in mid- to long-range planning efforts. Further, an interagency task force, that includes representation from the Department of Defense (the Office of the Secretary of Defense, Army, Navy, Air Force and Missile Defense Agency) and the National Aeronautics and Space Admin- istration, has been formed to offer solid rocket motor industrial base sustainment recommendations to the Secretary of Defense for a subsequent report to Congress. 404

QUESTIONS SUBMITTED TO GENERAL NORTON A. SCHWARTZ

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE Question. General Schwartz, to meet emerging requirements, the Air Force is quickly expanding its unmanned aerial vehicle and cybersecurity missions. It is adding thousands of highly trained personnel to these career fields in a short time. These new missions are currently very much in demand. Are you concerned about how the high operational tempo is affecting the morale of the airmen in these career fields? Answer. We are always concerned about the morale and welfare of our Airmen operating in high operational tempo environments. With respect to remotely piloted aircraft (RPA), we have experienced unprecedented growth as a result of the increasing demand for the capability these systems provide. Initially we had to make some tough choices that had an impact on our Airmen, but recently we have implemented initiatives that will ‘‘normalize’’ the RPA enterprise and reduce the overall operational tempo. The two major initiatives are developing specific career fields for RPA aircrews and increasing our training capacity. These efforts are already mitigating the stress the high operational tempo has placed on our manpower infrastructure. As we continue to normalize RPA operations, the stresses will be reduced further. With respect to cyber security, last year we activated Twenty-Fourth Air Force and aligned critical cyber capabilities under Air Force Space Command. These actions enhanced our capability to conduct the full spectrum of military cyberspace operations for U.S. Cyber Command and the combatant commanders, while improving our ability to operate and defend Air Force networks. We are not significantly expanding the number of Airmen performing cyber missions and current operational tempo is not adversely affecting morale. However, we are making a concerted effort to ‘‘operationalize’’ cyber by enhancing formal training and implementing certification processes to develop a corps of cyberspace professionals. These organizational and force development changes will greatly enhance the Air Force’s cyber capabilities. Question. General Schwartz, there is growing concern that there could be a lack of missile warning satellite coverage due to the continued delays in the Space-based Infrared High program. The Air Force terminated the third generation missile warning satellite program in fiscal year 2011. What is your plan to mitigate a potential gap in coverage? Answer. The Air Force response is classified and will be provided under separate cover. Question. Over the last 21⁄2 years, $5.3 billion has been provided through the In- telligence, Reconnaissance, and Reconnaissance Task Force to increase our knowledge of our enemies in Iraq and Afghanistan. The fiscal year 2011 request includes an additional $2.6 billion for this purpose. But the President and the Secretary of Defense have stated that we intend to withdraw another 50,000 troops from Iraq by this fall and will begin drawing down our Afghanistan force in mid-2011. General Schwartz, could you explain the need for more ISR capability for Afghani- stan while our troops are expected to begin their withdrawal at the same time? Answer. Intelligence, surveillance, and reconnaissance (ISR) has proven to be a critical force multiplier for our ground forces. With fewer eyes and ears on the ground as the combat forces are withdrawn, ISR will become even more important to ensure our remaining troops are in the right place at the right time and prepared for the threats they will face. Consequently, the Air Force has surged ISR to support U.S. Central Command requirements and will continue to adjust ISR capability to the theater as those requirements change. Additionally, the investments we have made and continue to make in improving our ISR capabilities are not limited strictly to operations within the U.S. Central Command area of operations. The funds we have expended, and are requesting this year, are intended to procure systems that can be deployed to any theater to meet warfighter ISR requirements. Question. General Schwartz, the fiscal year 2001 budget requests approximately $200 million for the next generation bomber, while the Quadrennial Defense Review states that the Air Force is reviewing options to modernize the bomber force. What is the status of this review and when will the Congress be informed of the next generation bomber acquisition strategy? Answer. The Air Force is performing analysis to ensure we fully understand how all potential long range strike options contribute to the country’s future national defense and the National Military Strategy before significant funds are committed. During the 2010 Quadrennial Defense Review, a Secretary of Defense-directed tiger 405 team was established to complete an in-depth study of long-range strike, including the Long Range Strike Platform (LRSP) need, requirement, and technology. The team’s conclusions were supportive of pursuing a new LRSP platform, but identified the need for additional analysis to explore options for reducing costs and accelerating fielding timelines. Based upon the need for additional analysis, the Sec- retary of Defense chartered a subsequent study to examine a broader array of long- range strike issues and options including the appropriate mix of long range strike capabilities; upgrades to legacy bombers; manned and unmanned force structure numbers; stand-off and penetrating platform ratios; stand-off cruise missile requirements; intelligence, surveillance, and reconnaissance demands; airborne electronic attack requirements; and conventional prompt global strike needs. RAND is supporting the analysis and the study results are expected to be available in the fall of 2010. Question. General Schwartz, the Air Force plan to cut 18 aircraft from the Air National Guard in fiscal year 2011 by retiring 6 C–130Es and transferring 12 C– 130Hs to the active component raised some concerns. The media reported that the Air National Guard was not consulted on this plan. I understand that further discussions are now taking place within the Air Force. Could you please tell the Com- mittee about the issues prompting the restructure and your current solution? Answer. As supported by the requirements identified in the recently released Mo- bility Capabilities and Requirements Study 2016 (MCRS 16), the Air Force is reducing excess mobility C–130 force structure by accelerating the retirement of the C– 130Es and retiring some of the oldest C–130Hs. This created a shortfall of legacy C–130H aircraft for the Formal Training Unit (FTU) at Little Rock AFB, Arkansas. The fiscal year 2011 President’s budget request proposed the transfer of 18 Air Re- serve Component C–130Hs to the Active Duty to cover this shortfall and support the FTU. This plan was developed as part of the Air Force’s Corporate Process, which included representation from the Air National Guard (ANG) and the Air Force Reserve (AFR). The Air Force, in close partnership with the ANG and the AFR, continued to analyze the best solution to address the FTU issue even after the fiscal year 2011 President’s budget was developed. The Air Force, including its Total Force partners, refined the original fiscal year 2011 President’s budget request to meet the needs of the C–130 schoolhouse while factoring in state mission concerns. The new proposal would allow the ANG and AFR to retain ownership of the 18 C–130Hs but still support the training needs of the FTU—with the C–130 schoolhouse transitioning from an Active Duty run program to an Air Reserve Component run program. Question. General Schwartz, we understand that the Air Force was concerned about having too much of the C–130 force in the Guard and Reserves. Can you shed some light on what problem is being solved with the proposed shift of aircraft to the active component? Answer. As supported by the requirements identified in the Mobility Capabilities and Requirements Study 2016 (MCRS 16), the Air Force is reducing excess mobility C–130 force structure by accelerating the retirement of the C–130Es and retiring some of the oldest C–130Hs. This created a shortfall of legacy C–130H aircraft for the Formal Training Unit (FTU) at Little Rock AFB, Arkansas. The fiscal year 2011 President’s budget request proposed the transfer of 18 Air Reserve Component C– 130Hs to the Active Duty to cover this shortfall and support the FTU. This plan was developed as part of the Air Force’s Corporate Process, which included representation from the Air National Guard (ANG) and the Air Force Reserve (AFR). The Air Force, in close partnership with the ANG and the AFR, continued to analyze the best solution to address the FTU issue even after the fiscal year 2011 Presi- dent’s budget was developed. The Air Force, including its Total Force partners, refined the original fiscal year 2011 President’s budget request to meet the needs of the C–130 schoolhouse while factoring in state mission concerns. The new proposal would allow the ANG and AFR to retain ownership of the 18 C–130Hs but still support the training needs of the FTU—with the C–130 schoolhouse transitioning from an Active Duty run program to an Air Reserve Component run program. Question. General Schwartz, the Joint Cargo Aircraft program is now an Air Force responsibility rather than a joint Army-Air Force program. Along the way, the previously validated requirement of 78 aircraft dropped to 38 aircraft. In testimony last year, several witnesses suggested that the JCA requirement may get a re-look during the Quadrennial Defense Review. Could you tell us what has happened with respect to the JCA requirement? Answer. In April 2009, the Office of the Secretary of Defense transferred the Joint Cargo Aircraft program to the Air Force, set the C–27J buy at 38 aircraft, and directed the Air Force to assume the Army’s time sensitive/mission critical direct sup- 406 port airlift mission. The Secretary of Defense’s intent was for the Air Force to use the new C–27J and existing C–130 aircraft to accomplish this mission. The Mobility Capability Requirements Study 2016 (MCRS–16) established the C– 130 tactical fleet size at 335 but did not assess fleet requirements to perform the direct support mission. Air Mobility Command, working with the U.S. Army and others, recently chartered a RAND study to better define the direct support mission and detail the required direct support fleet given a baseline of 38 C–27Js. Initial results of the RAND study are expected in the fall of 2010. Question. General Schwartz, what is the status of the basing plan for these aircraft? Answer. The Air Force is using a repeatable, defendable and transparent Stra- tegic Basing Process to identify locations for the C–27J. The National Guard Bu- reau, as the lead agency, developed training and operations basing criteria, which were approved by Secretary of the Air Force and myself and released to the Con- gress in April 2010. These criteria will be applied to create C–27J training and operations candidate base lists that will ultimately be approved by the Secretary and myself in July 2010. We anticipate releasing the preferred basing alternatives in December 2010 and completing the environmental impact assessment process by spring 2011. Question. The budget requests $66 million for a new program procuring 15 Light Mobility Aircraft. This new initiative expands your mission which, given the emphasis by Secretary Gates on reducing defense expenditures, appears unusual. General Schwartz, do you see any difficulty in manning new expeditionary units for this aircraft? Answer. The Air Force began deliberate planning to support the procurement of 15 Light Mobility Aircraft in the fiscal year 2011 President’s budget request which included adding civilian end strength to assist with the acquisition/procurement. The Air Force is currently finalizing the operations and associated military support manpower requirements as part of the process for building the fiscal year 2012 defense budget utilizing existing skill sets already resident in the inventory. Question. General Schwartz, is this initiative duplicative with the Special Oper- ations Command Foreign Internal Defense air advisory units? Answer. The Light Mobility Aircraft program is additive, not duplicative. It is designed to bring an aviation ‘‘building partner capacity’’ capability to general purpose forces. These aircraft will help partner nations with emerging air forces develop a basic airlift capability that will provide government presence, mobility, and other essential capabilities to the host nation. The capability to train, advise and equip partner nations’ air forces has traditionally been a mission in Air Force Special Oper- ations Command (AFSOC); specifically the 6th Special Operations Squadron. Al- though we have expanded the ability for this mission to be conducted in AFSOC— in past and coming years—we realize that the demand for this capability outpaces our ability to increase the mission within the special operations forces solely. As a result of this realization, and in compliance with the 2010 Quadrennial Defense Re- view Report, we are fielding light mobility aircraft in general purpose force units. Question. General Schwartz, is there an operational role for these aircraft for re- supplying American and coalition forces? Does this share a capability niche with the Joint Cargo Aircraft? Answer. While the LiMA and the C–27J will share some capabilities, including the ability to operate from short, rough, unimproved landing surfaces, the aircraft will perform two distinct missions. LiMA will primarily train Partner Nations in Air Mobility operations, while the C–27J will provide a dedicated airlift platform for U.S. and coalition forces. LiMA will enable the United States to acquire aircraft that are not only affordable, but also the right technology for many of our partner nations.

QUESTION SUBMITTED BY SENATOR PATRICK J. LEAHY Question. The decision in the Air Force fiscal year 2011 budget to pull C–130s from the Air Guard and Reserve into the active duty Air Force is troubling. One explanation offered for this decision was that these airframes were part of a legacy air mobility fleet of the least capable and oldest aircraft. However, no explanation was offered as to why the Air Force has chosen to stock the Air Guard and Reserve with its oldest aircraft. Why aren’t such airframes evenly spread across the components, rather than given mostly to the Guard and Reserve? Answer. The Air Force’s original fiscal year 2011 request to move 18 C–130s from the Air Reserve Component (ARC) to the Active Duty enabled retirement of the old- 407 est C–130Es, most of which resided within the Active component. Since then, the Air Force and ARC have accelerated a previously discussed approach to pass the C–130 legacy training requirement to the ARC. This plan eliminates the need to transfer ownership of the 18 aircraft in question to the Active component. Finally, both the Active and Reserve components possess a mix of older and newer C–130s.

QUESTION SUBMITTED BY SENATOR THAD COCHRAN Question. General Schwartz, NASA is proposing to rely on an emerging commercial space sector to meet future space exploration and launch needs, and I am informed that the Air Force has explored commercial launch services in the past with mild success. How has the commercial industry evolved with spacelift capabilities? More importantly, have you looked at government test facilities involvement to ensure that commercial industry maintains the necessary level of safety and reliability in launching national security space assets? Answer. The United Launch Alliance (ULA) is currently the sole U.S. provider of medium-lift to heavy-lift launch vehicles through the Evolved Expendable Launch Vehicle (EELV) program. ULA provides the Atlas V and Delta IV families of launch vehicles for national security space payloads. While EELV initially targeted a projected large commercial demand, the commercial launch market did not materialize and now the U.S. Government is driving the market for medium-lift to heavy-lift launch vehicles. A small number of EELVs have been procured commercially outside of the Air Force program office, such as the Intelsat-14 launch on an Atlas V on November 23, 2009, and by NASA for the NOAA Geostationary Operational Envi- ronmental Satellites. Emergent commercial launch providers for medium-class payloads, such as the Space X Falcon 9 and Orbital Taurus II, are receiving NASA funding via Commer- cial Orbital Transportation System contracts. The first launch demonstration flight for Falcon 9 was on June 4, 2010. The first planned launch of the Taurus II is in late June 2011. A number of U.S. Government test and range facilities support commercial space flight. The EELV program used NASA’s Plum Brook facility for payload fairing qualification; Arnold Engineering Development Center for upper stage engine testing; and Edwards AFB, California for Delta IV main engine testing. ULA continues to use NASA’s Stennis Space Center for main engine final assembly and test. Addi- tionally, all ULA launches, government and commercial, utilize the Air Force spacelift range facilities at the Eastern Range (Cape Canaveral AFS, Florida) and the Western Range (Vandenberg AFB, California). The testing and qualification performed at these government facilities are key contributors to the proven reliability of the EELV launch vehicles. It is our understanding that Space X employs organic facilities to meet their test needs while Orbital plans to use the Stennis facility for main engine final assembly and test. To meet their launch needs, Space X operates at the Air Force’s Eastern and Western Ranges and Orbital is building launch facilities at NASA’s Wallops Flight Facility. We are not aware of any other specific plans for these companies to use government facilities.

QUESTION SUBMITTED BY SENATOR SAM BROWNBACK Question. The Air Force is currently looking into the concept of light attack aircraft and may request funds to purchase these aircraft in the future. Does the Air Force plan on using light attack aircraft solely to train foreign militaries or are there plans for the Air Force to develop its own light attack fleet? Answer. The 15 light attack aircraft will be used for building partnership capacity training. A competitive acquisition strategy will be used to procure the 15 light attack continental U.S. based training aircraft in fiscal year 2012. The Air Force currently has no plans to develop an organic light attack fleet.

SUBCOMMITTEE RECESS Chairman INOUYE. This subcommittee will next meet on Tues- day, May 18, at 10 a.m., in a closed session, at which time we’ll be briefed on issues concerning the United States Pacific Command and the United States European Command. We will now stand in recess. 408 [Whereupon, at 12:14 a.m., Wednesday, May 12, the subcommittee was recessed, to reconvene subject to the call of the Chair.] DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, JUNE 16, 2010

U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10:30 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) presiding. Present: Senators Inouye, Leahy, Dorgan, Feinstein, Murray, Specter, Cochran, Bond, Hutchison, and Bennett. DEPARTMENT OF DEFENSE

OFFICE OF THE SECRETARY

STATEMENT OF HON. ROBERT M. GATES, SECRETARY OF DEFENSE

OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. This morning, the subcommittee welcomes Dr. Robert Gates, the Secretary of Defense, and Admiral Mike Mullen, the Chairman of the Joint Chiefs of Staff, to testify on the administration’s budget for fiscal year 2011. We welcome you and thank you for joining us. The administration has requested $540 billion for base budget for the DOD for fiscal year 2011, an increase of $18 billion over the amount enacted last year. Additionally, the administration has requested $159 billion in supplemental funding for overseas contingency operations in the next fiscal year, roughly equal to the supplemental funding requested for the current fiscal year. The base budget for DOD has nearly doubled in the last 10 years, and since 2001, we have spent close to $1 trillion on post 9/ 11 combat operations. Those are staggering numbers, to say the least, and warrant some judicial scrutiny on behalf of both the warfighter and the taxpayer. Mr. Secretary, last year, you set out to reform the Pentagon’s budget, and particularly by seeking greater balance in our force structure between competing requirements for irregular and conventional warfare. This year’s budget request continues this effort. One key theme you have emphasized in recent months is the need to provide an institutional home in the Department for the warfighter engaged in the current fight. We would agree with that, but as you well know, much of the critical force protection equipment that is used in the theater today (409) 410 has been funded outside the regular budget and is being managed by newly created and ad hoc organizations that we understood were to be temporary in nature. Yet even after several years at war, these task forces still haven’t transitioned to regular Defense Department operations. The Mine Resistant Ambush Protected Ve- hicle Task Force; the Intelligence, Surveillance, and Reconnais- sance Task Force; the Joint Improvised Explosive Device Organiza- tion; and the Helicopter Survivability Task Force come to mind. Last year, you even created a senior integration group to oversee efforts by these task forces. These organizations are not only largely funded with supplemental appropriations, they remain apart from the regular acquisition process and enjoy considerable flexible authorities, some of which are being interpreted quite broadly, to say the least. Mr. Secretary, when we met last year, you indicated to us that some of these task forces would disappear. So we would appreciate an update from you with respect to the transition plans. At the same time, conventional threats to our national security remain. We need only look at words spoken and actions taken in recent weeks by North Korea, Iran, and China to be reminded that our national security challenges go beyond those of irregular warfare. There is grave concern that with the current emphasis on irregular warfare capability, we could be losing sight of the conventional threats and degrading our ability to counter them. And finally, Mr. Secretary, in light of our Nation’s fiscal challenges, you recently stated that military spending should expect to receive harsher scrutiny. You mentioned large and small weapons systems, a review of Defense Department operations, and also the challenge of providing healthcare for our soldiers and veterans, quoting President Eisenhower’s truism that, ‘‘The patriot today is the fellow who can do the job with less money.’’ As you can imagine, those statements raise a few questions. So we hope you will take this opportunity to elaborate a bit further about what you have in mind. But before proceeding, Mr. Secretary, I would like to call upon our vice chairman for any comments he wishes to make. Senator Cochran. STATEMENT OF SENATOR THAD COCHRAN Senator COCHRAN. Mr. Chairman, thank you. I am pleased to join you in welcoming our distinguished panel of witnesses at the hearing this morning. We are reviewing the De- fense Department’s 2011 budget request. Mr. Secretary, I hope you can give the subcommittee your assessment of the timing of when the fiscal year 2010 supplemental appropriations will be needed to support combat operations. When you briefed the Senators last month, you suggested that the supplemental appropriations bill would be needed prior to Memorial Day. The Senate passed a supplemental appropriations bill last month. The funding level approved by the Senate was within the funding level requested by the administration. But we have seen no movement to enact this legislation by the other body, and I am concerned that we are well past Memorial Day, and any insights you can give us now as to what we face be- 411 cause of the lack of supplemental funding might be helpful and help generate a little more emphasis on the timeliness of the action by the Congress. So we thank you for being here, and we look forward to your testimony. Chairman INOUYE. I thank you very much. The show is yours, Mr. Secretary. SUMMARY STATEMENT OF HON. ROBERT M. GATES Secretary GATES. Thank you, Mr. Chairman, Senator Cochran, members of the subcommittee. Thank you for the opportunity to appear before you to discuss the President’s budget request for fiscal year 2011 for the Department of Defense. I first want to thank you, as always, for your support of the men and women in the U.S. military for these many years. I know they are uppermost in your thoughts as you deliberate on these budget requests. Our troops are part of an extraordinary generation of young Americans who have answered their country’s call. They have fought our country’s wars, protected our interests and allies around the globe, and they have demonstrated compassion and dedication in the face of tragedy and loss. The budget requests being presented today include $549 billion for the base budget, a 3.4 percent increase over the last year, or 1.8 percent real growth after adjusting for inflation, reflecting the administration’s commitment to modest, steady, and sustainable real growth in defense spending. The base budget request was accompanied and informed by the 2010 Quadrennial Defense Review (QDR), which establishes strategic priorities and identifies key areas for needed investment. The 2010 QDR and fiscal year 2011 request build upon the substantial changes that the President made in the fiscal year 2010 budget to allocate defense dollars more wisely and reform the Department’s processes. The base budget reflects these major institutional priorities. First, reaffirming and strengthening the Nation’s commitment to care for the All-Volunteer force, our greatest strategic asset. Sec- ond, rebalancing America’s defense posture by emphasizing both the capabilities needed to prevail in irregular conflicts and the capabilities that likely will be needed in the future. And third, continuing the Department’s commitment to reform of how the Depart- ment does business, especially in the area of acquisition. Building on the reforms of last year’s budget, the fiscal year 2011 request takes additional steps aimed at programs that were excess or performing poorly. They include terminating the Navy EPX intelligence aircraft; ending the Third Generation Infrared Surveil- lance Program; canceling the Next Generation CGX Cruiser; terminating the Net-Enabled and Control Program—Command and Con- trol Program; ending the Defense Integrated Military Human Re- sources System due to cost overruns and performance concerns; completing the C–17 program and closing the production line as multiple studies in recent years, including an outside study mandated by the Congress in 2008, show that the Air Force already has many more of these aircraft than it needs; and ending the second 412 engine for the F–35 Joint Strike Fighter (JSF), as whatever benefits might accrue are more than offset by excess costs, complexity, and associated risks. Let me be very clear. I will continue to strongly recommend that the President veto any legislation that sustains the continuation of the C–17 or the F–35 extra engine. And given some recent commentary, let me be explicit. It would be a very serious mistake to believe the President would accept these unneeded programs simply because the authorization or appropriations legislation includes other provisions important to him and to this administration. These reforms all require political will and a willingness to make hard choices. We are already beginning the next step in this process of reform as we prepare the fiscal 2012 budget. Last month, I called on the Pentagon to take a hard, unsparing look at how the Department is staffed, organized, and operated. This initiative is not designed to reduce the defense top line. I believe the current top line is the minimum needed to sustain a military at war and to protect our interests in the years to come in an ever more unstable and dangerous world. Rather, my goal is to significantly reduce our overhead costs in order to free up the resources needed to sustain our force structure, to modernize, and to create future combat capabilities while living within the current top line. To this end, the Department has recently set a goal to find more than $100 billion in overhead savings over the next 5 fiscal years, starting in fiscal year 2012. No organization within the Department, including my own office, will be excluded from these efforts. All of the savings will be applied to fund personnel and units, force structure, and investment in future capabilities. As a matter of principle and political reality, the Department of Defense cannot come to America’s elected representatives and ask for budget increases each year unless we have done a better job— indeed, done everything possible—to make every dollar count. Finally, in order to support ongoing operations, we are also requesting $159 billion in fiscal year 2011 to support overseas contingency operations (OCO), primarily in Afghanistan and Iraq, plus $33 billion for the remainder of this fiscal year to support the added financial costs of the President’s new approach in Afghani- stan. The commitments made and programs funded in the OCO and supplemental requests demonstrate this administration’s determination to support our troops and commanders at the front so they can accomplish their critical missions and return home safely. I discussed the Defense Department’s portion of the fiscal year 2010 supplemental request before this subcommittee in March and sought its approval by spring to prevent costly and counterproductive disruptions to the Department’s operations. I am becoming increasingly concerned about the lack of progress on the supplemental and strongly urge Congress to complete its work on the request as quickly as possible. I appreciate the Senate’s action on this request, but if the supplemental is not enacted by the July 4th congressional recess, we will have to begin planning to curtail defense operations. Such planning 413 is disruptive, can be costly, and especially in time of war, and I ask your help in avoiding this action. PREPARED STATEMENT In closing, Mr. Chairman, my thanks to you and members of this subcommittee again for all you have done to support our troops and their families, especially in light of the unprecedented demands that have been placed upon them. I believe the choices made in these budget requests reflect America’s commitment to see that our forces have the tools they need to prevail in the wars we are in, while making the investments necessary to prepare for threats on or beyond the horizon. Thank you. [The statement follows:]

PREPARED STATEMENT OF ROBERT M. GATES Mr. Chairman, members of the committee: Thank you for the opportunity to appear before you to discuss the President’s budget requests for fiscal year 2011. I first want to thank you for your support of the men and women of the U.S. military these many years. I know they will be uppermost in your thoughts as you deliberate on these budget requests. Our troops are part of an extraordinary generation of young Americans who have answered their country’s call. They have fought this country’s wars, protected our interests and allies around the globe, and they have demonstrated compassion and dedication in the face of tragedy and loss. The budget requests being presented today include $549 billion for the base budget—a 3.4 percent increase over last year, or 1.8 percent real growth after adjusting for inflation, reflecting this administration’s commitment to modest, steady, and sustainable real growth in defense spending. The base budget request was accompanied and informed by the 2010 Quadrennial Defense Review, which establishes strategic priorities and identifies key areas for needed investment. The 2010 QDR and fiscal year 2011 request build upon the substantial changes that the President made in the fiscal year 2010 budget to allocate defense dollars more wisely and reform the department’s processes. The base budget request reflects these major institutional priorities: —First, reaffirming and strengthening the nation’s commitment to care for the all-volunteer force, our greatest strategic asset; —Second, rebalancing America’s defense posture by emphasizing both the capabilities needed to prevail in irregular conflicts, and the capabilities that likely will be needed in the future; and —Third, continuing the department’s commitment to reform how DOD does business, especially in the area of acquisitions. Building on the reforms of last year’s budget, the fiscal year 2011 request takes additional steps aimed at programs that were excess or performing poorly. They include: Terminating the Navy EP(X) intelligence aircraft; ending the Third Genera- tion Infrared Surveillance program; canceling the next generation CG(X) cruiser; terminating the Net Enabled Command and Control program; ending the Defense Integrated Military Human Resources System due to cost overruns and performance concerns; completing the C–17 program and closing the production line, as multiple studies in recent years show that the Air Force already has more of these aircraft than it needs; and ending the second engine for the F–35 Joint Strike Fighter, as whatever benefits might accrue are more than offset by excess costs, complexity, and associated risks. Let me be very clear: I will continue to strongly recommend that the President veto any legislation that sustains the continuation of the C–17 or the F–35 extra engine. And given some recent commentary, it would be a serious mistake to believe the President would accept these unneeded programs simply because the authorization or appropriations legislation includes other provisions important to him and this administration. These reforms all require political will and a willingness to make hard choices. We are already beginning the next step in this process of reform as we prepare for the fiscal 2012 budget. Last month I called on the Pentagon to take a hard, unsparing look at how the department is staffed, organized and operated. This initiative is not designed to reduce the defense topline. I believe the current topline is the 414 minimum needed to sustain a military at war and to protect our interests in the years to come in an even more unstable and dangerous world. Rather, my goal is to significantly reduce our overhead costs in order to free up the resources needed to sustain our force structure, modernization, and future combat capabilities while living within our current topline. To this end, the department has recently set a goal to find more than $100 billion in overhead savings over the 5 fiscal years starting in fiscal year 2012. No organization within the department, including my own office, will be excluded from these efforts. All of the savings will be applied to fund personnel in units, force structure, and investment in future capabilities. As a matter of principle and political reality, the Department of Defense cannot go to America’s elected representatives and ask for budget increases each year unless we have done everything possible to make every dollar count. Finally, in order to support ongoing operations, we are also requesting $159 billion in fiscal year 2011 to support Overseas Contingency Operations, primarily in Afghanistan and Iraq, plus $33 billion for the remainder of this fiscal year to support the added financial costs of the President’s new approach in Afghanistan. The commitments made and programs funded in the OCO and supplemental requests demonstrate this administration’s determination to support our troops and commanders at the front so they can accomplish their critical missions and return home safely. I discussed the Defense Department’s portion of the fiscal year 2010 supplemental request before this committee in March, and sought its approval by spring to prevent costly and counterproductive disruptions to the department’s operations. I am becoming increasingly concerned about the lack of progress on the supplemental, and strongly urge Congress to complete its work on the request as quickly as possible. I appreciate the Senate’s action on this request, but if the supplemental is not enacted by the July 4th Congressional recess, we will have to begin planning to curtail defense operations. Such planning is disruptive, especially in time of war, and I ask your help in avoiding this action.

CARE FOR OUR ALL-VOLUNTEER FORCE The fiscal year 2011 budget request includes $138.5 billion for military pay and allowances, an increase of $3.6 billion—or 2.6 percent—over last year. This includes an increase of 1.4 percent for military basic pay, which will keep military pay increases in line with those in the private sector. This amount funds bonuses and other incentives to meet recruiting and retention quality and quantity goals—especially for our most critical skills and experience levels. The military deserves generous pay because of the stress and danger these jobs entail. In recent years, the Congress has added 0.5 percent to the administration’s requested military pay raise—an action that adds about $500 million a year to our budget now and in future years, and reduces the funds available for training and equipping the force. In this time of strong recruiting and retention, I urge the Congress to approve the full requested amount for the fiscal year 2011 military pay raise but not to add to the request. Wounded, Ill, and Injured This budget supports the department’s intense focus on care for our wounded, ill, and injured military members. As I’ve said before, aside from winning the wars themselves, this is my highest priority. Key initiatives include: —Achieving a seamless transition to veteran status for members leaving the military and increased cooperation between the Departments of Defense and Vet- erans Affairs; —Ensuring a high standard at facilities caring for wounded warriors, including first-rate hospitals and the Army’s Warrior Transition Units; —Enhancing case management of individuals transitioning to civilian life—especially those needing long-term care; —Establishing a better Disability Evaluation System—to create a simpler, faster, more consistent process for determining which members may continue their military service and helping them become as independent and self-supporting as possible; and —Working with the VA to create Virtual Lifetime Electronic Records to improve veteran care and services by improving the availability of administrative and health information. The fiscal year 2011 budget request includes $2.2 billion for enduring programs for our wounded, ill, and injured. It also includes $300 million to complete the Army’s Warrior Transition complexes and new medical facilities in the Washington, DC, capital region. The $2.2 billion for these programs is $100 million more than 415 the fiscal year 2010 enacted amount and is more than double the fiscal year 2008 level of $1 billion. Military Health System The fiscal year 2011 budget includes $50.7 billion for the Unified Medical Budget to support the Military Health System that serves 9.5 million eligible beneficiaries. Over the past decade, U.S. healthcare costs have grown substantially, and defense health costs have been no exception, more than doubling between fiscal year 2001 ($19 billion) and fiscal year 2010 ($49 billion). These costs are expected to grow from 6 percent of the department’s total budget in fiscal year 2001 to more than 10 percent in fiscal year 2015. Military Family Support Programs The department remains fully committed to providing assistance to our troops and their families in light of the unprecedented demands that have been placed on them. Our men and women in uniform and their families have our respect, our gratitude, and our full support. The budget reflects the department’s policy of shifting money to the base budget for enduring programs so that they will not disappear as war funding declines. The fiscal year 2011 base budget includes $8.1 billion for a variety of family-support programs vital to the morale and well-being of our military members and their families—an increase of $450 million over last year. The OCO request includes $700 million for family support—bringing the total to $8.8 billion. Build and Sustain Facilities The fiscal year 2011 budget includes $18.7 billion to fund critical military construction and family housing requirements, including substantial funding to recapitalize many department schools for children of service members. The fiscal year 2011 Base Realignment and Closure (BRAC) investment funding of $2.4 billion is less than prior years because most of the funding needed to implement the 2005 round of BRAC decisions has already been appropriated for 24 major realignments, 24 base closures, and 765 lesser actions—all of which must be completed by September 15, 2011, in accordance with statute. We have requested $14.2 billion to modernize the department’s facilities; to support the recently completed growth in the Army and Marine Corps; to support the relocation of 8,000 Marines from Okinawa to Guam; and to recapitalize medical facilities and schools for servicemembers’ children.

REBALANCING THE FORCE—THE WARS WE ARE IN Achieving our objectives in Afghanistan and Iraq has moved to the top of the institutional military’s budgeting, policy, and program priorities. We now recognize that America’s ability to deal with threats for years to come will largely depend on our performance in the current conflicts. The fiscal year 2011 budget request took a number of additional steps aimed at filling persistent shortfalls that have plagued recent military efforts, especially in Afghanistan. Rotary-Wing Aircraft To increase these capabilities, this request includes more than $9.6 billion for the acquisition of a variety of modern rotary-wing aircraft, including the creation of two Army combat aviation brigades by fiscal year 2014. The goal is to train 1,500 new Army helicopter pilots per year by 2012. Intelligence, Surveillance, and Reconnaissance (ISR) The fiscal year 2011 budget request continues efforts to increase ISR support for our fighting forces. The ISR Task Force was formed in April 2008 to generate critical operational ISR capacity—primarily in Afghanistan and Iraq. Since then, the department has worked to secure substantial funding to field and sustain ISR capabilities. In the fiscal year 2011 budget, that includes: $2.2 billion for procurement of Predator-class aircraft to increase the Combat Air Patrols (CAPs) available to deployed forces from 37 to 65 by 2013; and doubling procurement of the MQ–9 Reaper over the next few years. Electronic Warfare (EW) The fiscal year 2011 budget request supports the QDR’s call for better EW capabilities for today’s warfighters. The Navy procurement budget includes $1.1 billion in fiscal year 2011 and $2.3 billion in fiscal year 2012 for the addition of 36 EA– 18G aircraft, with 12 procured in fiscal year 2011 and 24 in fiscal year 2012. These resources and capabilities will help fill an imminent EW shortfall that has been consistently highlighted by the combatant commanders as one of their highest priorities. 416

Special Operations Forces (SOF) The fiscal year 2011 budget requests $6.3 billion for USSOCOM—nearly 6 percent higher than in fiscal year 2010. The department plans to call for SOF funding to increase sharply over the next several years, including an increase of about 2,800 personnel in fiscal year 2011.

REBALANCING THE FORCE—PREPARING FOR THE FUTURE The fiscal year 2011 budget includes $189 billion for total procurement, research, and development. This investment reflects the fact that the United States needs a broad portfolio of military capabilities with maximum versatility across the widest possible spectrum of conflict, including conventional conflict with the technologically advanced military forces of other countries. To meet the potential threats to our military’s ability to project power, deter aggression, and come to the aid of allies and partners in environments where access to our forces may be denied, this budget request includes substantial funds for conventional and strategic modernization. Tactical Aircraft—JSF The fiscal year 2011 budget funds programs to develop and buy superior aircraft to guarantee continued air dominance over current and future battlefields, most importantly the F–35 Joint Strike Fighter (JSF). The fiscal year 2011 base budget includes $10.7 billion for continued development of the F–35, and for procurement of 42 aircraft. An additional JSF is purchased in the OCO budget. I know the JSF program is of great interest and concern to this committee. In response to what I consider to be unacceptable delays and cost overruns over the past year, this department has taken a number of steps to substantially restructure this program. First, the JSF program is now based on numbers—cost and schedule estimates— from the Joint Estimating Team (or JET), an independent body known for its rigorous and skeptical assessments. Based on the new JET estimates, we reduced the number of aircraft being purchased concurrent with testing and development. While delaying full-scale production was not a welcome development—to put it mildly—it was important to avoid a situation where a problem discovered in testing would lead to expensive retrofits of aircraft, the most common reason for delays and cost overruns in these kinds of programs. Correspondingly, we have added more aircraft to the testing regime, which we believe will reduce the projected delay from 30 months to 13. These changes amount to a brutally realistic assessment of cost and schedule—one that I believe should stand the test of time and the legitimate scrutiny of the Congress and the American taxpayer. Furthermore, with regard to accountability, I have replaced the JSF program manager and elevated that position to a three-star billet while withholding more than $600 million in performance fees from the lead contractor. It is important to remember that the JSF’s cost- and schedule-related issues—and I regard them as serious, to be sure—are problems primarily related to program administration and management, not the technology and capability of the aircraft. The Joint Strike Fighter will do everything the military services need it to do, and become the backbone of U.S. air combat for the next generation. Mobility and Tanker Aircraft The fiscal year 2011 budget continues to support development of a new aerial refueling tanker. The KC–X, the first phase of KC–135 recapitalization, will procure 179 commercial derivative tanker aircraft to replace roughly one-third of the current aerial refueling tanker fleet at an estimated cost of $35 billion. Contract award is expected in the summer of 2010 and procurement should begin in fiscal year 2013. To support this long-range effort, $864 million has been requested for research into the next-generation tanker. The fiscal year 2011 budget ends production of the C–17, supports shutdown activities for production of new aircraft, and continues the modification of existing C– 17s. With the completion of the program, the United States will have 223 of these aircraft, more than enough to meet current and projected requirements. Shipbuilding The fiscal year 2011 budget reflects the department’s formulation of a realistic, executable shipbuilding plan through the Future Years Defense Program (FYDP). Overall, the fiscal year 2011 budget includes $25.1 billion for fiscal year 2011 procurement of new ships, equipment and research and development into future construction—including $15.7 billion for Navy shipbuilding and conversion activities. It reinforces the ongoing transition to a naval force that can meet the needs of today’s 417 warfighters and reduce reliance on very costly and increasingly vulnerable large surface combatants in the future. The fiscal year 2011 request and planned out-year funding would allow the department to: —Build a new aircraft carrier every 5 years; —Shift large-deck amphibious ship production to a 5-year build cycle to maintain a long-term force structure of nine large-deck aviation ships to support amphibious operations; —Stabilize near-term production quantities for the Littoral Combat Ship (LCS) and the Joint High Speed Vessel (JHSV) to support irregular warfare operations; —Produce two attack submarines per year beginning in fiscal year 2011 and continue development of a new strategic deterrent submarine; and —Build three Mobile Landing Platform (MLP) ships—one ship per year in fiscal year 2011, fiscal year 2013, and fiscal year 2015. Ground Forces Modernization The fiscal year 2011 budget advances restructuring of the Army’s Future Combat Systems (FCS), principally through Brigade Combat Team (BCT) modernization. The fiscal year 2011 request for BCTs is $3.2 billion, mostly for research and development. The fiscal year 2011 budget also supports the development of a new ground-vehicle program to replace aging systems. The new program will take into account the hard battlefield lessons of recent years, especially with respect to threats posed by improvised explosive devices (IEDs), and will include a role for the MRAP and M– ATV vehicles that have been so important in Afghanistan and Iraq. Space and Cyber Capabilities Just about all of our military forces—land, sea, and air—now depend on digital communications and the satellites and data networks that support them. The role of space and satellites has never been more crucial to military operations—from GPS-guided munitions and navigation to missile defense and communications. The fiscal year 2011 budget continues to strengthen U.S. capabilities in space, with $599 million allocated to procure Advanced Extremely High Frequency (AEHF) satellites instead of the Transformational Satellite, which was cancelled in the fiscal year 2010 budget. With cheap technology and minimal investment, adversaries operating in cyberspace can potentially inflict serious damage on our command and control, ISR, and precision strike capabilities. The fiscal year 2011 budget continues to fund the recruiting and training of new experts in cyber warfare begun in fiscal year 2010, and supports the stand up of a new U.S. Cyber Command. Ballistic Missile Defense The Department of Defense continues to pursue missile-defense systems that can provide real capability as soon as possible while taking maximum advantage of new technologies. In accordance with the 2010 Ballistic Missile Defense Review, our goal is a missile-defense program that balances capabilities and risks in order to deter aggression; project power and protect U.S. and allied interests; and respond to warfighter requirements. This year’s base budget request includes $9.9 billion total for missile defense— almost $700 million more than last year, mostly for the Missile Defense Agency. This includes funding for: —Enhanced missile defenses for deployed forces, allies, and partners to defend against regional threats—including THAAD battery ground components and interceptors, as well as the conversion of additional Aegis ships. —The ‘‘Phased Adaptive Approach’’ for missile defense: a flexible, scalable system to respond to developing threats. This has particular applicability to Europe, where the new approach allows us to adapt our systems more rapidly as new threats develop and old ones recede. In the short-term, we will be able to provide immediate coverage and protection by deploying current and proven systems such as the Aegis and SM–3. —A viable homeland defense against rogue threats—including ground-based interceptors at Fort Greeley, Alaska, and Vandenberg AFB, California. —Expansion of the flight-test program to test capabilities against medium, intermediate, and long-range threats. —Investments in break-through technologies to improve our ability to counter threats during the boost phase while focusing on the most promising new technologies. 418

Nuclear Weapons The Nuclear Posture Review (NPR) released in April outlined the policy framework for achieving the President’s objectives to reduce nuclear weapons with a long- term goal of elimination; and maintain a safe, secure, and effective arsenal as long as these weapons exist. It also provides steps to strengthen deterrence while reducing the role of nuclear weapons. The President’s budget requests for the Defense and Energy departments reflect several priorities established in our review: Fund- ing to sustain a nuclear triad of ICBMs, SLBMs, and heavy bombers under the New START Treaty; and increased National Nuclear Security Administration funding for infrastructure, warhead life extension, and science and technology. Maintaining an adequate stockpile of safe, secure and reliable nuclear warheads requires a reinvigoration of our nuclear weapons complex, that is, our infrastructure and our science, technology and engineering base. To this end, the Department of Defense is transferring $4.6 billion to the Department of Energy’s National Nuclear Security Administration through fiscal year 2015. This transfer will assist in funding critical nuclear weapons life-extension programs and efforts to modernize the nuclear weapons infrastructure. The initial applications of this funding along with an additional $1.1 billion being transferred for naval nuclear reactors are reflected in the Defense and Energy Departments’ fiscal year 2011 budget request, which I urge the Congress to approve. These investments and the Nuclear Posture Review strategy for warhead life extension represent a credible modernization plan to sustain the nuclear infrastructure and support our nation’s deterrent. Building Partner Capacity In a world where arguably the most likely and lethal threats will emanate from failed and fractured states, building the security capacity of partners has emerged as a key capability—one that reduces the need for direct U.S. military intervention, with all of its attendant political, financial, and human costs. To provide more resources, predictability, and agility to this important mission, the department will seek an increase in Global Train and Equip authority in the fiscal year 2011 budget to $500 million—authority that includes coalition activities to support current operations.

REFORMING HOW DOD DOES BUSINESS President Obama is committed to ending unneeded and troubled programs and achieving a better balance between capabilities needed to succeed in current conflicts and capabilities needed to prepare for the conflicts we are most likely to see in the future. The fiscal year 2011 budget request builds on the reforms of last year by ending a number of unneeded or troubled programs: —Next Generation Cruiser CG(X).—Cancelled due to concerns about costs and utility in future combat scenarios. Any resulting capability gap will be filled by an enhanced Navy destroyer program. —Navy Intelligence Aircraft EP(X).—This Navy-planned EP–3 replacement was cancelled because of cost and its redundancy with other technologies and systems. —Third Generation Infrared Surveillance (3GIRS).—This sensor system was cancelled because there are better alternatives. —The Defense Integrated Military Human Resources System (DIMHRS).— DIMHRS has been in development for over 10 years and cost $500 million— with little to show and limited prospects. —Net Enabled Command and Control (NECC).—This joint program has had cost overruns and performance shortfalls. JSF Alternate Engine One of the tougher decisions we faced during this budget process was whether or not to formally add the alternate engine to the Joint Strike Fighter program. It has been the position of this department since 2007 that adding a second JSF engine was unnecessary and too costly. Over the past year, as part of our thorough review of the overall JSF program, we took a fresh look to determine whether the second engine option had reached a point in funding and development that supported a different conclusion. We considered all aspects of this question and, in the end, concluded that the facts and analysis simply do not support the case for adding an alternate engine program. There are several rationales for this conclusion: First, even after factoring in Congress’ additional funding, the engine would still require a further investment of $2.5 billion over the next 5 years. 419

Second, the additional costs are not offset by potential savings generated through competition. Even optimistic analytical models produce essentially a break-even scenario. Third, the solution to understandable concern over the performance of the Pratt & Whitney program is not to spend yet more money to add a second engine. The answer is to get the first engine on track. Further, the alternate engine program is 3 to 4 years behind in development compared to the current program, and there is no guarantee that a second program would not face the same challenges as the current effort. Fourth, split or shared buys of items, particularly from only two sources, do not historically produce competitive behavior since both vendors are assured some share of the purchase. Another reality is that the JSF is designed to support a wide diversity of military customers, including the Navy, Marine Corps, and overseas buyers, many of whom are unable or unwilling to purchase from two engine manufacturers. For all these reasons, we are firm in our view that the interests of the taxpayers, our military, our partner nations, and the integrity of the JSF program are best served by not pursuing a second engine. I believe most proponents of this program are motivated by the genuine belief that a second engine is the right thing to do. And we have been engaging the Con- gress in this discussion and sharing with them our facts and analysis. However, we have reached a critical point in this debate where spending more money on a second engine for the JSF is unnecessary, wasteful, and simply diverts precious modernization funds from other more pressing priorities. Accordingly, should the Congress add more funds to continue this unneeded program, I will continue to strongly recommend that the President veto such legislation. C–17 The fiscal year 2011 request completes the C–17 program and begins shutting down the production line. At present, we have 194 C–17s (plus 111 C–5s) in our strategic airlift fleet. By the end of this fiscal year, the department will have procured 223. Three department studies completed over the past 5 years have concluded that the U.S. military has more than enough strategic airlift capacity, and that additional C–17s are not required. Some factors to consider: —In 2004, the Air Force Fleet Viability board determined that the fleet of C– 5As—the oldest variant—will remain viable until at least 2025. The Air Force and the manufacturer believe that the C–5 fleet will remain viable until 2040. And ongoing modernization and refurbishment efforts are intended to increase the reliability, availability, and maintainability of the C–5 fleet; —Despite the demands of the current military campaigns, the existing C–17 fleet is not being ‘‘burned up.’’ With the exception of 2003—when there were only 111 aircraft in the fleet that were being surged to begin the Iraq war—the annual use of the C–17 inventory has been within program limits; and —While it is true that the C–17 can land places where the C–5 cannot, of the 200,000 landings made by C–17s since 1997, less than 4 percent were in places that were not accessible to the C–5. In summary, for these and other reasons, the department has concluded that the current C–17 is more than sufficient to meet the military’s airlift needs. Should Congress add funds to continue this program, I will strongly recommend a Presi- dential veto. Acquisitions The department is implementing initiatives that will increase the numbers and capabilities of the acquisition workforce, improve funding stability, enhance the source-selection process, and improve contract execution. Our intent is to provide the warfighter with world-class capability while being good stewards of taxpayer dollars. To operate effectively, the acquisition system must be supported by an appropriately-sized cadre of acquisition professionals with the right skills and training to perform their jobs. To address these personnel deficiencies, DOD will increase the number of acquisition personnel by 20,000 positions—from about 127,000 in fiscal year 2010 to about 147,000 by fiscal year 2015. We will be making significant increases in training and retention programs in order to bolster the capability and size of the acquisition workforce. Civilian Workforce The fiscal year 2011 budget funds a pay raise of 1.4 percent for DOD civilians— the same as the military pay raise. The request includes funding to transition out 420 of the National Security Personnel System (NSPS)—as directed by the fiscal year 2010 National Defense Authorization Act. About 225,000 DOD employees are covered by NSPS. These employees must convert to a successor statutory personnel system. The fiscal year 2011 budget includes $23 million to implement NSPS transition and $239 million for estimated higher civilian pay for employees transitioning out of NSPS. The request supports the DOD plan, announced last year, to grow its civilian workforce by in-sourcing—replacing contractors with DOD civilian employees. DOD is on track to reduce the number of support service contractors from the current 39 percent of our workforce to the pre-2001 level of 26 percent, and replace them with full-time government employees. DOD will hire as many as 13,400 new civil servants in fiscal year 2010, and another 6,000 in fiscal year 2011, to replace contractors and up to 33,400 new civil servants in place of contractors over the next 5 years. This includes 2,500 acquisition personnel in fiscal year 2010 and 10,000 through fiscal year 2014. Fiscal Year 2010 Supplemental Request As the President stated, the goal of the United States in Afghanistan and Paki- stan is to disrupt, dismantle, and defeat Al Qaeda and to prevent its resurgence in both countries. The international military effort to stabilize Afghanistan is necessary to achieve this overarching goal. Rolling back the Taliban is now necessary, even if not sufficient, to the ultimate defeat of Al Qaeda and its affiliates operating along the Afghanistan-Pakistan border. I believe the strategy announced by the President represents our best opportunity to achieve our objectives in a part of the world so critical to America’s security. The fiscal year 2010 supplemental requests $33 billion to support the President’s buildup of U.S. troops in Afghanistan for the rest of this fiscal year and fund other related requirements, including $1 billion for Iraqi security forces. The Department of Defense urges the Congress to approve this Supplemental by July 4th for our troops in the field. The fiscal year 2010 Supplemental includes $19 billion to support an average troop level in Afghanistan of 84,000 U.S. troops—16,000 higher than the 68,000 assumed in the enacted fiscal year 2010 budget. Troop levels are expected to reach 98,000 by September 30, 2010. The additional troops will consist of: Two Army counterinsurgency Brigade Combat Teams (BCTs); an Army Training BCT; a USMC Regimental Combat Team (RCT); and enablers such as Explosive Ordnance Disposal teams. The supplemental also includes $1.1 billion—on top of the $11.3 billion already enacted—to field and sustain critically important lifesaving MRAPs and M–ATVs for troops already there and for the additional forces being deployed this fiscal year. Fiscal Year 2011 Overseas Contingency Operations To fund military operations in Afghanistan and Iraq in fiscal year 2011, we are requesting $159.3 billion, comprised of these major categories: —Operations ($89.4 billion).—Incremental pay for deployed troops, subsistence, cost of mobilizing Reserve Component personnel, and temporary wartime end- strength allowances. —Force Protection ($12 billion).—Body armor, protection equipment, and armored vehicles to protect forces—including the rapid deployment and sustainment of MRAPs and M–ATVs. —IED Defeat ($3.3 billion).—To develop, procure, and field measures to defeat improvised explosive devices threatening U.S. and coalition forces. —Military Intelligence ($7 billion).—To enhance U.S. intelligence capabilities and operations including ISR. —Afghan Security Forces ($11.6 billion).—To build and support military and police forces capable of conducting independent operations and providing for Af- ghanistan’s long-term security. —Iraqi Security Forces ($2 billion).—To continue building and sustaining Iraq’s efforts to defend its people and protect its institutions as the United States re- moves troops by the end of 2011. —Coalition Support ($2 billion).—Reimbursements and logistical sustainment for key cooperating nations supporting U.S. military operations. —Commander’s Emergency Response Program (CERP) ($1.3 billion).—To provide flexible funds for commanders in the field to finance urgent humanitarian and reconstruction needs. —Reconstitution/Reset ($21.3 billion).—To fund the replenishment, replacement, and repair of equipment and munitions that have been consumed, destroyed, or damaged due to ongoing combat operations. This request includes funding to 421

procure one Joint Strike Fighter aircraft to replace the combat loss of an F– 15. —Military Construction ($1.2 billion).—To expand the logistical backbone and operational foundation for our fighting forces. —Temporary Military End Strength ($2.6 billion).—To support temporary end- strength increases in the Army and Navy for ongoing military operations. —Non-DOD Classified Programs ($5.6 billion).—To fund non-DOD classified activities that support ongoing military operations—the President’s counter-terrorism strategy in Afghanistan and Pakistan, and the drawdown of U.S. forces in Iraq. Iraq Force Levels This request supports the President’s goal of a responsible drawdown of U.S. forces and transfer to full Iraqi responsibility and control. Troop levels in Iraq are projected to decrease to 50,000 by August 31, 2010. Further reductions will occur in accordance with the U.S.-Iraq Security Agreement. The projected forces levels would be: Six Advisory and Assistance Brigades (AABs) by August 31, 2010; and six AABs for the first part of fiscal year 2011, decreasing to approximately four AABs (approximately 35,000 personnel) in Iraq by the end of fiscal year 2011.

CONCLUSION Mr. Chairman, my thanks to you and members of this committee for all that you have done to support our troops and their families. I believe the choices made and priorities set in these budget requests reflect America’s commitment to see that our forces have the tools they need to prevail in the wars we are in while making the investments necessary to prepare for threats on or beyond the horizon. Thank you.

STATEMENT OF ADMIRAL MIKE MULLEN, U.S. NAVY, CHAIRMAN, JOINT CHIEFS OF STAFF

BUDGET SUBMISSION Admiral MULLEN. Chairman Inouye, Senator Cochran, distinguished members of this subcommittee, thank you for the chance to discuss the state of our military, as well as the President’s fiscal year 2011 defense budget submission. As always, I greatly appreciate your extraordinary support of the men and women of the United States armed forces, their families, and the communities that do so much to help them. In particular, I thank you for your passing the fiscal year 2010 supplemental request. Our men and women in uniform are well equipped, well trained, well paid, and receive the finest medical care in the world due in no small part to your dedication and stewardship. I am here today to secure your continued support. Secretary Gates has walked you through the major components of the budget submission, and I will not repeat them. Let me leave you, rather, with three thoughts worth considering as you prepare to debate the details. First, there is a real sense of urgency here as we work to win the wars we fight. We have more than 200,000 troops deployed in harm’s way right now and another 150,000 or so deployed in support of other security commitments around the world. For the first time since 2003, we have more troops in Afghani- stan than in Iraq, where we remain on pace to draw down to roughly 50,000 troops by the end of August. The bulk of the 30,000 additional forces the President authorized for Afghanistan are in country, and the remainder, less than 10,000, will arrive in the next 2 months. 422 These forces are now and will continue to be focused on operations in the central Helmand Valley, and Marjah and Kandahar specifically. You have, I am sure, been keeping abreast of what we are trying to achieve there, but I think it is important here to just summarize. Kandahar is the birthplace of the Taliban insurgency. It is far— it is from there that they have tried to spread their influence across Afghanistan, and it is from there that they desire to rule once again. I think it is safe to say that they still believe in their cause. In and around Kandahar they train, equip, plan, and intimidate. Just the other day, in a village not far away, these people lynched a small boy of 7, claiming he was a spy for the coalition. I know very well that in a counterinsurgency you fight not for the territory, but for hearts and minds. But it is from Kandahar that the Taliban attempt to control the hearts and minds of the Af- ghan people. It is my belief that should they go unchallenged there and in the surrounding areas, they will feel equally unchallenged elsewhere. As goes Kandahar, so goes Afghanistan. SECURITY OUTPOSTS Afghan and coalition efforts there have already begun. Indeed, they have been underway for several months, consisting primarily of what we call shaping activities—kinetic strikes against Taliban targets and their facilities, as well as meetings with tribal elders aimed at securing their support. You saw President Karzai down there just this past weekend, holding a share of his own and completing the effort of getting local backing. We turn now to the all-important task of improving security. With Afghans in the lead, we will bolster a police presence at security outposts and checkpoints in and around the city. We will establish freedom of movement along the Ring Road and build a by- pass south of Kandahar. And we will better control access to the city itself along its main arteries. None of this will be easy. None of this will be bloodless, as events last week grimly attest. But all of it will depend heavily on the continued growth and development of competent and well-led Afghan national security forces, as well as tangible and achievable political outcomes. Securing Kandahar—or rather securing the people of Kandahar—is not a military objective. It is a social, political, and economic objective for which other agencies and other nations are needed and through which Afghan leadership will be vital. I am comfortable with the progress to date and the sequencing that we are following. But I am also mindful of the need to monitor our progress continually, to stay flexible, and to adjust accordingly. That leads me to the second thing I would like you to consider— proper balance. Winning our current wars means investment in this hard-won irregular warfare expertise, a core competency that should be institutionalized and supported in coming years. But we still face traditional threats from regional powers who possess robust regular and in some cases nuclear capabilities, and so we must also maintain and sustain our conventional advantages. In the air, this means sufficient strike aircraft and munitions capable of assuring air superiority. At sea, it means having enough 423 ships and enough sailors to stay engaged globally and to keep the sea lanes open. On the ground, it means accelerating the modernization of our combat brigades and regiments. On the whole, it means never having to fight a fair fight. Again, it is about balance, about deterring and winning the big and small wars, the conventional and the unconventional—two challenges, one military. ADVOCACY PROGRAMS But where balance is probably most needed is in the programs and policies concerning our most important resource, our people. And that is my final point. This budget builds upon the superb support you and this Department have provided our troops and their families, stretched and strained by nearly constant combat, many of them on their fifth, sixth, and some even their seventh deployments. Our men and women are, without question and almost inexplicably, the most resilient and battle-ready force in our history. We are turning away potential recruits, so good is our retention and so attractive are our career opportunities. Yet we keep seeing an alarming rise in suicides, marital problems, prescription drug addictions, and mental health problems within our ranks. Deborah and I meet regularly with young troops and their spouses. And though proud of the difference they know they are making, quite frankly, many of them are worried about their fu- tures, their livelihoods, their children. And so, you will see in this budget increases for family support and advocacy programs, and you will see a boost in warfighter and family services to include counseling, military spouse employment, and care for our wounded, ill, and injured. We are also pushing to dramatically increase the number of mental health professionals on staff and advance our research in traumatic brain injuries and post traumatic stress. We know the strain of frequent deployments causes many problems. But we don’t know yet fully nor understand fully how or to what extent. So even as we work hard to increase dwell time, time at home, aided in part by the additional temporary end strength you approved last year for the Army, we will work equally hard to decrease the stress of modern military service. Indeed, I believe, over time, when these wars are behind us, we will need to look closely at the competing fiscal pressures that will dominate discussions of proper end strength and weapons systems. A force well suited for long-term challenges and not necessarily married to any current force planning construct will remain vital to our national security. PREPARED STATEMENT Thank you, Mr. Chairman. And I look forward to your questions. [The statement follows:]

PREPARED STATEMENT OF ADMIRAL MICHAEL G. MULLEN Chairman Inouye, Senator Cochran, distinguished members of the Committee; it is my privilege to report on the posture of the United States Armed Forces. 424

I begin by thanking you for your support of our servicemen and women, their families, and the communities that do so much to help them. We can never repay them for their sacrifices, but we can support them. As leaders, we necessarily debate the best course of action to secure our nation in a dangerous world. But our servicemen and women do not hesitate. When the decision is made, they go where they are needed most, where dangers must be confronted and adversaries defeated. I’m humbled as I visit them around the world, defending our nation in very trying conditions. They care deeply for this country, and they care most that they have the nation’s clear backing. The support of the Congress and the American people remain essential to their strength and resolve. I am grateful for your unwavering recognition of the service of our forces and their families. Today’s Armed Forces are battle-hardened, capable, and ready to accomplish the nation’s missions. They are the most combat experienced yet most compassionate force we have ever fielded, and continue to learn and adapt in ways that are truly remarkable. They are the best I have ever seen. I thank the Committee for taking the time to understand the stresses, strains and concerns of our service members. Your continuing legislative support of our Armed Forces makes all the difference.

KEY DEVELOPMENTS Over this past year, our wartime focus has shifted to Afghanistan and Pakistan. As I have testified before the Congress on many occasions, the threats to our national security from al Qaeda and affiliated movements based in the Afghanistan- Pakistan region remain real and persistent. We require a stable and reasonably secure Afghanistan and Pakistan—inhospitable to al Qaeda’s senior leadership, capable of self defense against internal extremist threats, and contributors to regional stability. Our increasing focus on Afghanistan and Pakistan confirmed the border region to be al Qaeda’s center of gravity. It also showed the situation to be more dire than previously understood. The Afghan-Taliban’s post-2005 resurgence produced a widespread paramilitary, shadow government and extra-judicial presence in a majority of Afghanistan’s 34 provinces. The Tehrik-i-Taliban Pakistan (the Pakistan Taliban) showed itself to be a bold and audacious enemy of the Pakistani people, ruthlessly seizing control of Swat in the late spring of 2009 and conducting a brutal series of attacks across the nation in recent months. Multiple Pakistani military operations against the Taliban that began last year have reversed their territorial gains. Throughout this year, we have constantly and carefully reviewed our objectives for the region. The decision to authorize an additional 21,500 American forces into Af- ghanistan in early 2009, followed by the President’s commitment of 30,000 additional forces in December set conditions to reverse Afghan-Taliban gains. It will also enable the government of Afghanistan to build the security and governance necessary to eliminate the insurgency as a threat. With a new leadership team, appropriate resources, improved organization, and a better strategy, we are confident of success against al Qaeda and the Taliban. Success will not come easily or swiftly, but we will succeed. The hardest work to achieve our regional aims remains ahead of us, especially the last part of 2010 and into 2011. Al Qaeda’s central leadership has suffered significant losses over the past several years, to include the likely death of one of their founders, Sheik Sa’id al-Masri. Though its operational capacity has declined, al Qaeda’s senior leaders remain committed to catastrophic terrorist attacks against the United States and our allies, as evidenced by the intended attack against New York City that was disrupted in Den- ver and the recent failed attempt to detonate a vehicle-borne bomb in Times Square. Actions in the Pakistan-Afghanistan border area, in Iraq, and elsewhere have met with marked success. That said, al Qaeda sought new approaches to plot attacks. The failed Christmas Day airline bombing attempt over Detroit was crafted by and ordered from those in Yemen’s growing safe havens. Both incidents demonstrate the resolve of al Qaeda and its ever-evolving strategy. While the danger remains real, like-minded governments and people around the world—including those in the Mus- lim community—increasingly reject al Qaeda, its affiliates and what they stand for. Most want a brighter future for their children and grandchildren, not al Qaeda’s endless war and intolerance. They see daily evidence that al Qaeda and its affiliates deliberately target and kill thousands of innocent Muslims in cold blood. They know al Qaeda continues a ruthless and deadly campaign against innocent people in Iraq, Pakistan, Afghanistan, Saudi Arabia, Kenya, Indonesia, and elsewhere. Continued progress against violent extremism will require enhanced, but prudent, partnerships with key governments and movements, including consistent efforts to counter al Qaeda’s bankrupt message. 425

The actions of the Iranian government are of grave and growing concern. Tehran’s leadership remains on a trajectory to acquire a nuclear capability—an issue of global concern—in defiance of international demands and despite widespread condemna- tion. Iran’s government continues to support international terrorist organizations, and pursues a coercive and confrontational foreign policy. These efforts exist alongside growing divisions between elements of the government and between the government and the people. These events and conditions risk further destabilizing an already unstable region. Established threats also demonstrated they could flare at any moment, testing our resolve and dedication to long-standing allies. North Korea’s violation of the Armi- stice Agreement by sinking of a Republic of Korea corvette illustrates the dangerous nature of that still ongoing conflict. We must be ready to stand shoulder-to-shoulder with free countries and face down aggression when the situation demands it. The unpredictable has also galvanized our military, requiring a significant force commitment in Haiti, making it one of our most significant humanitarian missions in history. Nearly 20,000 American troops deployed to support the Government of Haiti, the United Nations, USAID and over 20 American and international aid agencies from January through the late spring. From port openings, to security and distribution of supplies, U.S. Southern Command’s military Joint Task Force performed admirably. Furthermore, your military was called on to help contain one of the worst environmental disasters in the history of the United States. From aircraft moving personnel and equipment as well as spraying dispersant, to imagery, sonar and communication support, the Department of Defense has provided whatever equipment and technology has been requested. Over 1,500 National Guardsmen are currently assisting with the oil spill, and the Administration has authorized up to 17,500 National Guard troops from Gulf Coast states to respond as needed. Several recent policy initiatives have provided the military with new direction. We concluded negotiations with Russia for a START follow-on treaty, which will reduce nuclear weapons stockpiles while maintaining U.S. deterrence. As I have testified, I strongly endorse this treaty and ask you to ratify it. We also completed the Nu- clear Posture Review, with significant implications for the military’s nuclear posture. And, as mandated by the Congress, we have reviewed current and future threats and developed appropriate strategies in the Quadrennial Defense Review, which supports the President’s recently released National Security Strategy. This Security Strategy rightly sharpens our focus on countering weapons of mass destruction and proliferation of such weapons, particularly to terrorist groups. Achiev- ing all the goals of these new policy initiatives will require improvement in both our conventional and nuclear forces. We look forward to working with the Congress to forge a common understanding of the threats our nation faces, and how best to counter them. Recent events have reminded us of the importance of sustaining strong alliances. Our NATO allies and other non-NATO partners expanded support in Afghanistan over the past year. We now work there with more than 40 countries and over 40,000 international troops. Although the world avoided a widespread economic depression in 2009, many of our partners remain financially challenged and may spend less on combined security and stabilization efforts. Our close alliance with Japan, in particular, suffered strain around basing rights in Okinawa, but we seek to move forward with them in implementing a plan. The recent DPRK torpedo attack reinforced the importance of a robust U.S. military presence on the Korean Peninsula and in the broader region. As we stand by our close allies, I am confident that we can work through these issues, but it is a reminder that we should neither take our strongest allies for granted, nor underestimate the persistent tensions and threats. Against this backdrop, the strategic priorities for the military remain unchanged from my last annual testimony before Congress: defending our interests in the broader Middle East and South/Central Asia; ensuring the health of the Force, and balancing global strategic risk. With your ongoing help and support, we continue to address each of these priorities.

DEFEND OUR INTERESTS IN THE BROADER MIDDLE EAST AND SOUTH/CENTRAL ASIA The Broader Middle East and South/Central Asia, remains the most dangerous region of the world. Our main effort within the region has changed. The government of Iraq is taking firm control of its own security. We have shifted our priority to Afghanistan and Pakistan, long under-resourced in many ways. That shift in focus includes the movement of some quarter of a million troops and their equipment in and out of the CENTCOM theater in the space of several months. This is a herculean logistics effort, but one we are successfully executing. Afghanistan is approaching parity with 426

Iraq for the first time since 2003 as the location with the most deployed American forces. Despite this surge, the security situation in both Afghanistan and Pakistan remains serious. The Afghan-Taliban have established shadow governments—fea- turing parallel judicial, taxation and local security/intimidation systems—in a majority of Afghanistan’s 34 provinces. Attacks by the Taliban have become far more numerous and more sophisticated. We are now establishing conditions—with military forces and expanded civilian agency presence—to reverse the Taliban’s momentum. Yet we face both a resilient Taliban insurgency and an Afghan public skeptical of their government’s good will, capacity and capability. As of mid-June 2010, we have moved roughly 20,000 troops to Afghanistan, with the remainder of the 30,000 increase arriving as rapidly as possible over the summer and early fall, making a major contribution to reversing Taliban momentum this year. The remainder of these forces will join some 90,000 U.S. forces and more than 40,000 Coalition forces already in Afghanistan—all of which have undertaken a fundamental shift in how they are being employed across the country. Our troops are now focused on protecting key population centers—separating them from the intimidation and influence of the Taliban. Simultaneously, they are training and partnering with Afghan security forces to enable Afghans to assume lead security for their own country as soon as possible. The recent peace jirga was an important Afghan-led step in this process. The next 12 months must be the time to reverse insurgent momentum and assess partnership progress. The brave men and women we charge to implement this fundamental shift in Af- ghanistan security strategy need the strong support of this Congress. We need your assistance in key areas like funding for Afghan National Security Forces, who will ultimately bring about success and security. In the short term, the Commander’s Emergency Response Program is needed to adequately protect the population, and enhanced special construction authorities and equipment procurement accounts will be critical to putting enough force on the ground to make a difference. The border area between Pakistan and Afghanistan is the epicenter of global terrorism. This is where al Qaeda plans terrorist attacks against the United States and our partners—and from where the Taliban leadership targets coalition troops in Af- ghanistan. Pakistan’s ongoing military operations against extremists in these areas are critical to preventing al Qaeda and associated groups from gaining ground. In Pakistan, the extremist threat, a fractious political system, economic weakness and long-standing tensions with India continue to threaten stability. We are working to rebuild our relationship with Pakistan and re-establish trust lost between our two countries. We aim to demonstrate to Pakistan—in both our words and our actions—that we desire a long-term relationship. The recent Strategic Dialogue with Pakistan, hosted by the State Department and supported by the Defense Depart- ment, reflects the value both our countries place on the friendship and support of the other. Our recent concerns with Pakistan’s approach to U.S. visa requests is further testimony to the challenges of the relationship; and, it will affect increased capacity for counterterrorism and counterinsurgency, to include support for development projects. The State Department’s Pakistan Counterinsurgency Capability Fund and the DOD’s Coalition Support Funds allocated for Pakistan are essential components of our support to this critical ally. Enhanced contact and engagement between Pakistan and the United States is a critical component of a maturing, long-term partnership. Thus, we are focusing on expanded military education exchange programs, joint training opportunities and especially Foreign Military Sales and For- eign Military Financing. The State Department budget requests additional funds for these critical partnership endeavors. South Asian security tensions and political dynamics significantly impact our objectives in Afghanistan and Pakistan. The longstanding animosity and mistrust between Pakistan and India complicates regional efforts. Yet India and Pakistan must both be our partners for the long term. Bilateral military relationships are an essential component in a wide array of cooperative activities. We must recognize this and address it as part of our policy. While we acknowledge the sovereign right of India and Pakistan to pursue their own foreign policies, we must demonstrate our desire for continued and long-term partnership with each, and offer our help to improve confidence and understanding between them in a manner that builds long-term stability across the wider region of South Asia. As part of our long-term regional approach, we should welcome all steps these important nations take to revive a process to resolve their differences over Kashmir. While Afghanistan and Pakistan remain the critical terrain, we must remain vigilant in denying al Qaeda unfettered physical safe havens elsewhere across the Broader Middle East and South Asia, including Northern and Eastern Africa. These efforts will not require tens of thousands of American troops. Instead, we can work 427 quietly and persistently with regional allies and Coalition partners to deny al Qaeda territory from which to plot, train, and project global terror operations. Similarly, we continue to undertake collaborative, supporting efforts with like-minded governments across the broader Middle East. We work to help the Yemeni government build the information base and the military capacity necessary to combat the al Qaeda threat within its borders. We applaud Yemeni efforts to confront al Qaeda operatives, and continue to offer Sana’a the support necessary to achieve this aim. We have worked with the concerned neighbors of Somalia to contain the worst aims and objectives of the Islamic Courts Union and al Shabaab. This must continue. In these areas—as well as others including Indonesia and the Philippines—our military engages with willing partners in a manner detrimental to al Qaeda’s aspira- tions. We undertake these partnerships in conjunction with those from American intelligence, diplomatic and economic organizations. I must stress that in today’s environment, training and equipping partner security forces to defend and protect their own territory and coastal waters is a core national security objective. We appreciate Congress’ continuing support for these important undertakings. The Iranian government continues to be a destabilizing force in the region. Tehran’s leadership remains on a trajectory to acquire a nuclear capability, in defiance of its international obligations. Indeed, the United Nations just declared Iran had sufficient fissile material to build two nuclear devices. A nuclear Iran could spark a regional arms race or worse. It will be profoundly destabilizing to the region, with far-ranging consequences that we cannot fully predict. Tehran also continues to provide a range of support to militant organizations, including HAMAS and Hizbollah, fomenting instability outside its borders. Its increasingly reckless nuclear and foreign policy agenda is now playing out against the backdrop of a slowing economy and profound internal turmoil. I remain convinced that exhaustive—and if necessary coercive—diplomacy with Iran remains the preferred path to prevent these grave outcomes. Iran faces an increasingly clear choice—cooperate with the international community or face consequences. To this extent, the Joint Chiefs, Combatant Commanders, and I support all efforts to steer the government of Iran off of its hazardous course. However, as with any potential threats to our national security, we will have military options ready for the President, should he call for them. Iraq continues to progress, although more is needed. U.S. partnership with Iraqi security forces has been fundamental to this progress since 2005. Al Qaeda is still present and has carried out several large-scale attacks. Iraqi Security Forces and government leaders responded to them vigorously yet professionally. Further, the Iraqi people show no renewed appetite for the brutal tactics of Al Qaeda; I believe Iraqis are now more focused on developing their economy than domestic security threats. Politically, the March 2010 elections were assessed as legitimate and were largely free of violence. Though the government transition has been drawn out beyond our original planning assumptions, there has been no degradation in the security situation. In turn, U.S. Forces—Iraq (USF–I) will draw down to roughly 50,000 and end our combat mission by August 31, 2010, as highlighted by our recent turnover of the Green Zone to the Iraqi government. Our security partnership will then shift to training, advising, and supporting Iraqi security forces, including continued participation in NATO’s Training Mission—Iraq. More broadly, the U.S. military will transition from a supported to a supporting effort in Iraq as we normalize relations. The State Department and other civilian agencies will increasingly be the face of U.S. efforts in Iraq. The U.S. military will strongly support their leadership. We appreciate the inclusion of the Equipment Transfer Provision in the 2010 National De- fense Authorization Act. These transfers are a critical component of America’s continuing actions as a reliable partner in Iraq’s assumption of a responsible and Bagh- dad-led security future.

HEALTH OF THE FORCE Our nation’s security is founded upon a well-trained, well-equipped all volunteer force. We must care for our people and their families, reset and reconstitute our weapon systems, and take on new initiatives that increase wartime effectiveness. Care for our People Our servicemen and women, their families, and their communities are the bedrock of our Armed Forces. Their health, resilience and well-being are at the heart of every decision I make. Frankly, investing in our people remains the single greatest guarantee of a strong military. Competitive pay, selective bonuses, expanded access to mental healthcare, continued health benefits for tens of thousands of our Wound- 428 ed Warriors—those with seen and unseen wounds—and their families are critical to this investment. Our military families and communities continue to play a unique and growing role in our national security fabric, one not seen in more than a generation. They support us and sustain us in ways we do not yet fully understand. They deserve the admiration and support of a grateful nation. My conversations with spouses and children around the world tell me these concerns center on caring for those affected by these wars, child care, education, health and employment issues. We remain competitive in attracting the country’s best talent. For the first time in the history of the All Volunteer Force, the Active Duty, Guard and Reserve components all exceeded annual recruiting goals for 2009. This success was reflected in the quality of our recruits as well as their numbers. Ninety-six percent of our accessions earned a high school diploma or better. Each Service also met or exceeded its 2009 retention goals. Our ability to recruit and retain underscores the fact that this is the best military I have seen in my 42-year career. While competitive pay is a critical factor in this success, it does not stand alone. Other critical ‘‘people’’ programs supported by the Congress—like the new GI Bill, adequate housing, access to quality schooling for military children, adequate child care, and attractive family support centers—come together to make the harsh burdens of military life acceptable. We must not forget the challenges that this excellent All Volunteer Force faces every day. More than 8 years of wartime operations have come at a cost. Most Army brigade combat teams are preparing for their fourth major deployment since 9/11, with some of them preparing for their fifth—unprecedented in our history. The Ma- rines Corps is in the same boat—their deployments are shorter but more frequent, and their pace is grueling. Our people spend less time at home, and this shorter dwell time between deployments does not allow for respite or for training along the entire spectrum of military operations. Our irregular warfare expertise—hard won over the last 81⁄2 years—has come at a price. Conventional war fighting skills have atrophied and will require attention. Yet this overdue attention will have to wait. The gains we anticipate from the coming draw-down in Iraq will be absorbed by our necessary efforts in Afghanistan for at least 2 more years. Resetting the force requires significant effort and sustained commitment now and post-conflict. We will continue to rely heavily on our Navy and our Air Force. Dwell time—the ratio of time deployed to time home—remains a concern, and one we must manage closely this year and into 2011. Dwell time for the Army is at 1:1.2 and the Marine Corps is slightly better at 1:1.5. We will not see significant dwell time improvements across all services until 2012. Deployment rates for Special Op- erations Forces (SOF) and other low-density, high-demand specialties also remain very high. While our force is strong and resilient, these trends cannot continue in- definitely. The challenges remain significant, but are manageable thanks to the support of Congress for increased end-strengths in the Army and Marine Corps. We are only now starting to feel the positive impact from these 2007 authorized increases in the baseline force—stabilizing deployment rates and dwell times. Coupled with the additional temporary increase of 22,000 troops within the Army, Congressional support for our wartime military manning needs has been critical. The stresses of protracted war extend beyond the deployments themselves. Our number of dead and wounded continues to rise, as does the strain on their families and their communities. Other social costs of war—divorce, domestic violence, depression, and post-traumatic stress syndrome—are unacceptably high and continue to increase. We have much more to do. Suicide deserves special attention. Despite our best efforts, 2009 witnessed a record level of suicides, with increases in both the Active and Reserve components. We have not begun to study suicides among family members and dependents. While there is not one cause for increased service-member suicides, we know enough to be certain that better prevention training programs for leadership, for at-risk service members, and robust funding and attention toward sober study of the problem are absolutely necessary. We should provide a lifetime of support to our veterans. I urge you to continue funding the programs supporting those that have sacrificed so much, including those aimed to reduce veteran homelessness and that focus on rural healthcare options. The demands on our active and veterans care services will continue to grow, and require the attention found in this budget. Yet we must conceive of Wounded War- rior Support in a manner that goes beyond the traditional institutions. Public, private, and individual sources of help represent a ‘‘sea of goodwill’’ towards our veterans. Our focus must be more on commitment than compensation; and more at- 429 tuned to transition and ability than upon disability. Our veterans want the opportunity to continue to serve, and we should enable that opportunity. Reset and Reconstitute My concerns about the health of our force go beyond our people. Our systems and capabilities are under extraordinary stress as well. The high pace of operations is consuming our capital equipment much faster than programmed. The Air Force and Navy have been essentially performing non-stop, global operations for 19 years, since Operation Desert Storm. The Army and Marine Corps have had the majority of their combat forces and equipment in the combat theater of operations for nearly 6 years. The unforgiving terrain of Afghanistan and Iraq causes extensive wear and tear, especially on our ground vehicles, helicopters, and supporting gear. The demands of the current fight mean we must increase capacity in several areas, including rotary wing, ISR, electronic warfare and SOF. We sustain necessary rotary wing capacity through the addition of two active Army Combat Aviation Bri- gades, continued production of the tilt-rotor V–22, as well as our helicopter force, and a seventh SOF helicopter company. I support this budget’s rebalancing in favor of more commercial airborne ISR capabilities for Combatant Commanders. This budget continues increasing the number of unmanned combat air patrols, coupled with the ability to fully exploit the intelligence coming from these platforms. We should expand current technologies to fill electronic warfare shortfalls and develop next-generation technologies for manned and unmanned aircraft. New initiatives Too many of our processes and programs remain geared to a peacetime clock, but several new initiatives focused on supporting our war efforts show promise. I strongly support the Afghanistan/Pakistan Hands program and ongoing initiatives that increase the number and skill of our civil affairs and psychological operations personnel. I also strongly back the USAF’s initiative to use light aircraft for enhanced capacity building of key allies and partners for light mobility and attack. Our current acquisition process remains too unwieldy and unresponsive. Adding 20,000 more acquisition experts by 2015 will help, as will increasing the rigor and efficiency of our internal processes. Stability in our programs, comprehensive design reviews, better cost estimates, more mature technology and increased competition will make the process more responsive. Once fielded, our systems are the finest in the world, because of the experienced and capable program managers and engineers building them. We need more of managers and engineers, and they need better support and leadership. Finally, I am growing concerned about our defense industrial base, particularly in ship building and space. As fiscal pressures increase, our ability to build future weapon systems will be impacted by decreasing modernization budgets as well as mergers and acquisitions. We properly focus now on near-term reset requirements. However, we may face an eroding ability to produce and support advanced technology systems. Left unchecked, this trend would impact war fighting readiness. The Department, our industry leaders, and the Congress need to begin considering how to equip and sustain the military we require after our contemporary wars come to an end.

BALANCING GLOBAL STRATEGIC RISK Balancing global risk requires sustained attention to resetting the force. It also means making prudent investments to meet the challenges of an increasingly complex and challenging worldwide security environment. As the President recently noted, it is the United States that has helped underwrite global security with the blood of our citizens and the strength of our military. America’s interests are global, and our military must secure these interests. Where possible, we will act first to prevent or deter conflict. When necessary, we will defeat our enemies. And whenever able, we will work in concert with our many allies and partners. For many decades, but especially since 1989, U.S. conventional overmatch has guaranteed our security and prosperity, as well as that of our many allies and partners. We have helped protect expanding global commons. We have seen the likelihood of conventional war between states drop. And we have used the tools designed for war not against human adversaries, but instead to support humanitarian operations. Most recently in Haiti, but elsewhere over the past 60 years, the military’s unmatched capacity to transport goods and services have provided relief in the face of tragic natural disasters. In short, many nations have benefited from an extraordinarily capable and ready U.S. military, even as we have defended our own interests. 430

That capability must continue to span the full range of military operations. But in this post-Cold War era—one without a military near-peer competitor—we should not be surprised that adversaries will choose asymmetric means to confront us. They will seek to use both old and new technology in innovative ways to defeat our advantages. Terrorism will remain the primary tactic of choice for actors to conduct warfare ‘‘on the cheap’’. Both state and non-state actors will seek weapons of mass destruction through proliferation. Increasingly, states will attempt to deny our ability to operate in key regions, through the development and proliferation of ballistic missile systems, or by exploiting space and cyberspace. Taken together, these are diverse threats that require a broad set of means. Winning our current wars means investment in our hard won irregular warfare expertise. That core competency must be institutionalized and supported in the coming years. However, we must also stay balanced and maintain our advantage in the conventional arena. In the air, this advantage requires sufficient strike aircraft and munitions capable of assuring air superiority and holding difficult targets at risk. At sea, we require sustained presence and capacity supported by a robust ship building program. On the ground, we must accelerate the modernization of our combat brigades and regiments. Without question, these are expensive undertakings. But our present security challenges demand them. While maintaining our conventional edge, we also must address the safety and surety of our nuclear forces, even as we seek to reduce them. Our Nuclear Posture Review provides the guidance and vision on how to accomplish this laudable and historic goal. We must invest in our nuclear infrastructure and modernization programs in order to ensure our smaller nuclear force is safe, secure, and reliable. Countering weapons of mass destruction means investing in new research, securing nuclear materials, and preparing a layered defense. Improving our ability to neutralize and render safe critical targets is vital. We maintain the ability to respond to their use against our citizens. But while improving responsiveness to the use of such weapons is critical, it is more important to counter their proliferation and deter their use. I advocate diverse investments in nuclear forensics and expanding our biological threat program, in addition to continuing investment in the highly effective counter-proliferation programs that are central to our success in this critical endeavor. These relatively small funds will have a disproportionately large positive impact on our security. The ability of potential adversaries to challenge our freedom of movement and the peaceful use of the global commons has grown in recent years. Anti access-technologies and capabilities are proliferating, which could prevent us from deterring conflict in some regions. We must preserve our ability to gain access even when political, geographical or operational factors try to deny us the same. This requires funding for improvements to our missile defense capabilities, expanded long range and prompt global strike systems, and hardened forward bases. Threats in cyberspace are increasing faster than our ability to adequately defend against them. Cyber attacks can cripple critical infrastructure, impose significant costs, and undermine operational capabilities. Meanwhile, space-based systems critical to our global awareness and connectivity are aging and have proven vulnerable. A determined enemy could degrade existing space systems, significantly impacting our strategic intelligence and warning capabilities, as well as global positioning and communication. I welcome your support for the recently stood-up U.S. Cyber-Com- mand (CYBERCOM) and its associated funding. Rising states present both a strategic challenges as well as strategic opportunities. China’s economic strength, military capability, and global influence continue to grow. While our military relations continue to develop, we seek much more openness and transparency from China regarding the pace and scope of its conventional and nuclear force modernization. We also believe that China can—and should—accept greater responsibility for and partner more willingly to safeguard global prosperity and security. We are looking to China to join us in reacting to the Cheonan sinking in ways that make clear to North Korea that its aggressive behavior is unacceptable. We seek for Beijing to work more collaboratively when determining fair access to transportation corridors and natural resources. China also should demonstrate greater clarity in its military investments. Absent a more forthcoming China in these critical areas, our military forces must prudently consider and plan based on known Chinese capabilities and actions, in addition to its stated intentions. As we work with Beijing to establish a continuous military-to-military dialogue to reconcile uncertainties and generate confidence, we will pursue common interests in agreed upon areas such as counter-piracy, counter-proliferation, search and rescue, humanitarian assistance and disaster relief. As a Pacific Rim nation with longstanding interests throughout the area, we will continue to play a vigorous regional role. 431

Our present dialogue with Russia is multi-faceted. It acknowledges points of con- tention as well as opportunities to ‘‘reset’’ our relationship on a positive trajectory. We welcome Moscow’s cooperation in reducing the number and role of strategic nuclear weapons. These discussions have been constructive, and I believe the resulting treaty will benefit the United States, Russia, and the world. Moscow has also helped us establish a supplemental logistics distribution line into Afghanistan. Russia also helped our diplomats pressure Iran, and we look toward Moscow to do even more in this process. On the other hand, Russia continues to reassert a special sphere of influence with its neighbors. The Russian military is simultaneously modernizing its strategic forces and many conventional forces. North Korea continues to present a security challenge in Asia, as evidenced by the recent sinking of a Republic of Korea corvette. Today, Pyongyang continues to pursue intercontinental ballistic missile technologies, develop nuclear technologies, and export weapons in contravention of international norms on nonproliferation, and of two United Nations Security Council resolutions. It also maintains an unfor- tunate and threatening posture toward our ally the Republic of Korea, and an unhelpful disposition toward our ally Japan. Of course, we can best defend our interests and maintain global order when we partner with like-minded nations. By forging close military-to-military relations with an expanding number of nations—providing training, equipment, advice, and education—we increase the number of states that are interested and capable of partnering with us. While tending to long-term allies, we should also cultivate our relationships with other liked-minded powers around the world. Making a small investment now will pay dividends in reducing our security burden and global risk. We must also continue to work with our traditional Allies. NATO remains the most successful alliance in history, and our NATO Allies serve side by side with us in Afghanistan and elsewhere. Our obligations under Article 5 remain clear, and our commitment to defending against threats—wherever they may originate—to our security and that of our Allies is unwavering. We need full funding of Defense Theater Security Cooperation programs, and the many security assistance programs managed by the Department of State, particularly the International Military Education and Training program. Preventative strategies require providing foreign partners with the capacity to promote stability and counter-terrorism. With your help, we have made considerable strides in adapting our tools for security force assistance, but more is needed. I urge your continued support of the Global Train and Equip initiatives (under 1206 authorities) as well as funding for special operations to combat terrorism (under 1208 authorities). The majority of threats facing the United States require integrated interagency and international initiatives. Supporting interagency cooperation programs, to include expanding the number of exchanges between the Department of Defense and other Executive Agencies, will improve interagency capacity to meet future security threats as well. Please urge your colleagues who oversee the Department of State to fully fund Secretary Clinton’s requests. I ask the Congress to promote legislation that increases the expeditionary capacity of non-military Executive Agencies. Our future security concerns require a whole of government effort, not just a military one.

CONCLUSION This past year witnessed significant achievements by America’s men and women in uniform. Their efforts and sacrifices—as part of a learning and adapting organization—have sustained us through more than 8 years of continuous war. Thanks to them we are in position to finish well in Iraq. Thanks to them, we can begin to turn the corner in Afghanistan and Pakistan. In conjunction with our many partner nations, they’ve provided humanitarian relief assistance to millions, helped contain a threatening H1N1 pandemic, expanded support to national law enforcement for enhanced border security, and disrupted terrorist sanctuaries worldwide. And, thanks to them, we have a global presence protecting our national security and prosperity. The demands of the present remain high, and our military role in national security remains substantial. This will continue for the foreseeable future. Yet as I have testified before this body in past appearances, the military serves America best when we support, rather than lead United States foreign policy. On behalf of all men and women under arms, I wish to thank the Congress for your unwavering support for our troops in the field, their families at home, and our efforts to rebalance and reform the force to assure that we win the wars we are in and are poised to win those we are most likely to face in the future. Chairman INOUYE. Thank you very much, Admiral Mullen. 432 I believe you are aware that the vote has started. That is why some of the members have left to vote, but they will be back. JOINT STRIKE FIGHTER I would like to begin, Mr. Secretary, by asking a question on the Joint Strike Fighter (JSF). Your projection has been shown to have a few predictions that are not quite correct. For example, the cost has increased by, I believe, $109 billion. Your chief weapons buyer has indicated that there are many problems in the Strike Fighter testing program. My question is, with these errors, should we still go along with your insistence upon no alternative engine? Secretary GATES. Yes, sir, I believe that is the case. In fact, I believe it very strongly. First of all, we are talking about two different subjects here, the fighter itself and the alternative engine. We had an independent estimating team in 2008 that identified some difficulties in the development program. I added almost $500 million—or you added almost $500 million at my request to that program. We did another independent estimating effort last fall that made it clear this was more than a 1-year problem, and we have completely restructured the program. We fired the program manager, replaced him with one of the most experienced acquisition uniformed officers in the military. We withheld $600 million plus from the contractor. We extended the development program. We slowed the production rate in the early years by 122 aircraft over a 3- or 4-year period. So we will have more aircraft—fewer aircraft that are completed while the development program is continuing. We have added three aircraft to the development program. So I think that we have taken a number of steps that are con- sonant with a restructuring of the program. We believe we have— because of these outside estimating efforts, we think we have a much better fix on the nature of the problem that we have faced. I would tell you it is not particularly a good news story, but I would point out that both the C–17 and the F–22 also went through restructurings early in the program because of problems. The good news, I would say, is that there hasn’t been a single review that has discovered any fundamental technological or performance problems with the aircraft. It is meeting its performance parameters. What we think we have endured is primarily management and production problems, a lack of adequate execution on the part of the Defense Department itself. My favorite story here is the supplier where the F–35 is part of their factory. They have a number of aircraft. The F–35 occupies 6 percent of the factory floor space, and we pay 70 percent of the overhead for the factory. So we need to be a lot smarter about the way we execute this program. So I think that we have a good independent assessment of where we are. I think part of the problem with this program, frankly, over the last several years has been too rosy an estimate from the production program itself about how things were going. And I think we have a much more realistic approach now. 433

ALTERNATE ENGINE With respect to the alternate engine, we have had this discussion. We believe that this program will cost at least another $2.9 billion to bring it to the point where it could be competitive. We think that the current engine that General Electric (GE) is offering probably does not meet the performance standards that are required, and the taxpayer would be required to pay for any enhancement that would bring it up to the performance standards that we require. And we think a situation in which both competitors are guaranteed a win is not competition at all. My view is a competition is winner take all. And I think we have had that competition, and it is time to move on with the program. Chairman INOUYE. Mr. Secretary, if I may follow up, we were under the impression that the testing program of the F–35 would be completed by 2012. And now we have been advised that it is going to slip to 2016. Secretary GATES. The dates that we have, Mr. Chairman, the latest information that I have is, first of all, we are on track to have a training squadron at Eglin Air Force Base in 2011. The Marine Corps will begin to receive their first aircraft in 2012, the Air Force in 2013, and the Navy in 2014. Full operational capability for the Air Force and the Navy will be in 2016. But those services will begin to receive aircraft earlier. Chairman INOUYE. I thank you very much. HEALTHCARE PROJECTIONS I would like to ask the Admiral about healthcare projections that you have made—and I am pleased to hear those—but my time will be up soon. As you know that the ancient war, World War II, and the conflict today cannot be compared. For example, in my time, in my combat team, 4 percent were married and had dependents, 96 percent were single. Today, I note that the Army, nearly 70 percent have dependents, and that produces a big problem. Second, survivorship is sky high now because of your improvement in high technology and transport. Do you think that we are coping with these changes? Admiral MULLEN. Sir, as I said in my opening statement, I think we have got the best healthcare system in the country. Where I have tried to focus on in addition to care, and we still have some challenges, is really the cost. And the cost has grown from $19 billion I think in 2001 to $50 billion—over $50 billion in 2011. And it is going to continue over the next few years to grow. So we have got to have a balance in terms of providing this high- quality care and somehow containing the costs, and the costs continue to grow. And as you indicated very clearly, the requirements for our families have grown substantially over the many years. That said, I don’t think there is any more important focus in our future than to make sure we get it right not just for our people, but also our families. And we still have some significant challenges internal to the De- partment in providing care. The Secretary of Defense and I talk 434 about this routinely. When we are on the road, we spend time with spouses, and particularly spouses in deployed units, that medical care continues to be at the top of their list to get it, as good as it is. In recent years, we have unsuccessfully recommended that the copay rates, which have not increased since 1995, be looked at to increase. I don’t see how at $19 billion in 2001, $50 billion in 2011, $64 billion, I think the number is, in 2015, it is just simply not sustainable. So my emphasis these days, and I know the Secretary’s as well, is how do we contain the costs? Senator COCHRAN [presiding]. Thank you very much, Admiral Mullen. Now I call on Senator Bond for any questions he has of the witnesses. Senator BOND. Thank you very much. I better turn this on. Thank you very much, Mr. Vice Chairman. FORCE STRUCTURE Secretary Gates, Admiral Mullen, we appreciate your service. I thank you for, first of all, when you say you are looking for savings of $100 billion in 5 years, we would humbly suggest that you put more, not less, in the force structure for the Guard, which is a bargain for our military defense. But I thank you for your recent decision to move forward with the F/A–18 multiyear. This pragmatic decision will help address larger fighter shortfalls in the Navy, save the taxpayer over $500 million. I believe strongly we take for granted our defense base will always be there, maintaining capacity and innovation to keep the United States and our warfighters second to none. I agree with the chairman that our ability to respond to current and emerging threats is dependent on preserving the ability to engineer, design, and procure both counterinsurgency technologies that we are employing today and technology to maintain our conventional military edge. In less than a decade, more than 50 major defense companies have been consolidated into only 6, and six aircraft primes have been narrowed to only two. After 2013, we will be down to one. The latest QDR has recognized and said how important and complex the industrial base is, but I would like to know what the Depart- ment of Defense and the administration are doing to ensure that we have the skilled workers, engineers, and companies both to address the threats to our Nation now and in the future. And one of the challenges of sustaining the defense base comes from a reduction in the overall number of programs. There are fewer new start programs, less investment in research and development, longer lifecycles, and increased cost for programs, especially like the JSF, that result in fewer efforts being underway. And I think a telling example is saying we shouldn’t purchase any more C–17s. The mobility capability study will not address the possibility that the Nation may need to surge its production of airlifters in response to a national emergency or a humanitarian crisis like Haiti. And I question the validity of a single study which doesn’t take into consideration the need of an industrial base. 435

C–17S The decision on the C–17 is particularly troubling because there will not be a single facility in North America anywhere assembling large aircraft designed to military specifications, and many of the old C–5As are reaching the end of their service life. I question why it is in our Nation’s interest to close the only active production line for long-range airlifters when there is no replacement that is being developed. And my question is what steps are being taken to protect the industrial base in heavy airlift, strategic airlift? Secretary GATES. Well, first of all, Senator, there have been three mobility studies done on the size of our strategic lift capability— one in 2005; one in 2008, sponsored and mandated by the Con- gress; and one in 2009. And those studies have taken into account a stressed strategic environment, as well as increased end strength in the military, the ability to carry large-scale, larger equipment such as mine resistant ambush protected (MRAP), and so on. There is the capability in the United States for wide-body aircraft. U.S. manufacturers make them all the time. The C–17 will have a very long lifespan. Those that are being built now will probably be flying in 35 to 40 years. So we have a substantial capability that takes into account really all of the stressed environments, and I think that we do have in the United States a capability—an industrial base that is capable of building wide-body aircraft and, over the period of time that we are looking at, the ability to adapt whatever is needed to meet military specifications. But the C–17 is going to be with us for decades. Senator BOND. But the C–5A is reaching its service life, and we are going to need replacements, aren’t we? Excuse me, Admiral Mullen. I didn’t see you were wanting to speak. Admiral MULLEN. As far as that is concerned, the studies, which have been extensive, look at both the C–5s and the C–17s. And the requirement, I cannot find a requirement for additional C–17s. As hard as we have looked, and quite frankly, because this is visited— been visited so many times, we have looked at it time and time again. We just don’t have a requirement beyond the 223 C–17s, and there are some that would argue that that is actually too many. I certainly share your concern with respect to the industrial base, and there is no easy answer there across a broad set of capabilities for our country. And the only way that I have seen that successfully addressed in the past is a strategic relationship—which includes obviously the partnership, if you will, between the Hill, between the Department of Defense, and those who build it—to make sure that we look at meeting our requirements and our ability to sustain a very important industrial base at an affordable cost. And that then gets into acquisition and how we do things. So I certainly take your point, Senator, about the industrial base. It is critical. But I don’t think from the standpoint of retaining it or sustaining it, one, against a requirement that doesn’t exist anymore, and second—and doesn’t look like it will exist for an extended period of time, and second, at an affordability level that we 436 just have not seen. That is the concern. I just think we have to address this strategically in ways we haven’t in the past. Senator BOND. Thank you very much, gentlemen. I will have questions I will submit to you in writing, if you don’t mind. Thank you. Senator COCHRAN. Senator Hutchison, I think you are next, and then Senator Specter. We are going to try to recognize folks in the order in which they came in. Senator Hutchison, you may proceed. Senator HUTCHISON. Thank you. Senator COCHRAN. Then I will call on Senator Hutchison—Sen- ator Murray, sorry. Senator HUTCHISON. Mr. Chairman, thank you. And I want to thank all of you for being here. Mr. Secretary, we have talked about your mission to try to lower the defense budget and you are looking for places to cut, and I am hoping that I can expand on this in the near future with you. But here are some of the concerns that I have seen as the ranking member and former chairman of the Military Construction Sub- committee. We have had a strategy of after we saw the deployment problems that we had when we were going into Iraq out of Germany, and also as we were looking at the training constraints in Germany and other parts of the world where we are. So we have had a strategy, and this just gives you an idea of the chart on Milcon buildup in the United States, starting in fiscal year 2006. We built up heavily in 2009 and 2010 to try to bring our troops home from Germany, some from Korea, to be able to train and deploy where we had complete control. But now I am looking at the 2011 budget request for Germany, and it is $500 million. And of greater concern is—this is the Milcon in Germany for the next 5 years, and we are looking at $3.5 billion in the next 5 years in Germany. Now I am concerned that we are duplicating efforts, and let me just give you an example in Ger- many. The European Command and the African Command are headquartered in Stuttgart. And yet the Army is now coming in to request $91 million for a SCIF facility in Wiesbaden, plus a new battle command center for $120 million in Wiesbaden. So the Army is going to a separate location, when we already seem to have our resources consolidated in Stuttgart. The German building requirements are higher, and yet Germany has only over the past 13 years contributed approximately 7 percent of the building requirements in Germany. And then you look at the effort that is being made by Germany in Afghanistan right now, approximately 4,000 troops out of approximately 100,000 in Afghanistan. And I guess I am just looking at the potential for savings and consolidation and efficiencies in military construction, and I am asking you if that has been a factor in your decisions, if you have looked at this plan for $3.5 billion in Germany, and what is the thinking behind that? And is it necessary to do that much when we have had the strategy of building up in America and deploying 437 where we wouldn’t have deployment problems as we saw going into Iraq? Secretary GATES. I will have to ask the Army to come up and brief you on the details and the justification of their specific programs. I would say more broadly that the path that we have been on was a path on global posture review that was established by the Bush administration. One of the outgrowths of the Quadrennial Defense Review was a request to revisit that issue by the Obama administration, and we are in the process of doing that this year in terms of our presence not just in Germany, but elsewhere around the world. And so, the conclusions of that study and whatever decisions the President makes on that will obviously significantly impact the kind of programs that you are describing. Senator HUTCHISON. When you are looking at budgetary matters and when the commanders in the field are making these requests, do you look at the effort made by the host country? I look, for instance, as a comparison to what Germany has done, to Japan, which has been above 90 percent in effort to help offset our costs. And Germany has asked us to stay, in many places. So is that a focus that the Department makes in general? Secretary GATES. It certainly is a consideration. Senator HUTCHISON. Well, there are also concerns that I have with Korea—— Senator COCHRAN. Senator, your time is expired. Senator HUTCHISON. I hope to be able to give you some thoughts that I have and perhaps work with you to see if we can be more efficient with the military construction side in the future. Thank you. Thank you, Mr. Chairman. Senator COCHRAN. Thank you, Senator. We established, under Senator Inouye’s rule, that we would recognize Senators in the order in which they came into the hearing. And this is the list that we have had. Senator Leahy was here early and had to leave, but he is back now. Senator Murray is next, Senator Dorgan, Senator Feinstein, Senator Specter, Senator Bennett. That is the list in order of the chairman. Senator MURRAY. Mr. Chairman? Mr. Chairman, I just had a chat with Mr. Specter, who did have another engagement. I am happy to go after him on that list. Senator COCHRAN. I was going to recognize Senator Leahy. Sen- ator Leahy. And here is the real chairman, so—— Senator LEAHY. Thank you. Did you ask questions? Okay. Secretary and Admiral Mullen, it is always good to see you. I appreciate the fact that both of you have always been available for questions from not only myself, but other members of the subcommittee. AFGHANISTAN Let me ask you a little bit about Afghanistan. We all want to see al-Qaeda, Taliban, defeated, but I worry about our clear, achievable goals there. I supported—9, 10 years ago now—going into Afghani- 438 stan to get Osama bin Laden. I did not support going into Iraq because I saw it as no threat to the United States. Secretary, you said last January we weren’t trying to make Af- ghanistan a Central Asian Valhalla. But I am not sure what we are trying to make it. Right now, the top officials in Kabul do not have the confidence or respect of the Afghan people. They seem to be making common cause with a lot of people that we are fighting. We have committed so much, so much money here, and we have neglected so many things inside the borders of the United States. We see China and now others developing green technology, creating jobs, exporting it to elsewhere. We see a number of other things in other countries where they don’t have the burdens of Afghanistan and Iraq. They are using the money to develop economic juggernauts, which could create huge problems for us in the future. We have 1,000 brave members of the Vermont National Guard there. And I want to thank you publicly, Admiral Mullen, for coming up and speaking to them. It was a highlight for them, the fact that you did. So, I mean, how do you see it? What is our end game? Secretary GATES. Well, first of all, I think one of the results of the very detailed analytical effort and policy consideration effort of the administration last fall was, in fact, to clarify our goals. And our goal is to ensure that Afghanistan is not a place from which attacks can be launched on the United States again. And in a nutshell, the strategy is to reverse the momentum of the Taliban, to deny them control of populated areas, to degrade their capabilities to the point where the Afghan security forces can take care of them. And the Afghans are ahead of pace, in terms of building both the police and the army. We still are dealing with quality issues, but we are making headway. We are making progress on trainers. The percentage of trainers to trainees has gone from about 1 to 80 to about 1 to 30. I read a lot in the press about corruption and so on and so forth, but the reality is there are ministers in Kabul doing their jobs, and there are Afghan soldiers and police out there who are dying in even greater numbers than we are, fighting for their country. Senator LEAHY. I met a number of those ministers, and I have a great deal of confidence in them. But do you have confidence in the top leadership of the country? Secretary GATES. Yes, I do. First of all, from my own conversations with President Karzai, I think that he is embracing his responsibility for this conflict in his country. His visit to Kandahar just a few days ago that the Admiral referred to was very important, in terms of helping set the stage for the continuation of the campaign there. So I think that we have some clear goals. I think, frankly, that the narrative over the last week or so, possibly because of the higher casualties and other factors, has been too negative. I think that we are regaining the initiative. I think that we are making headway. But the thing that I would say—two other points I would make, Senator is, people need to remember we have only been at this new 439 strategy for about 41⁄2 months. We don’t even have all the surge troops in Afghanistan. Senator LEAHY. Could I ask you on this, before my time runs out, is the Leahy law being implemented in both Afghanistan and Paki- stan? Secretary GATES. We are working to ensure that the Leahy law is being implemented in both places. And we could discuss it further with you in a closed setting. Senator LEAHY. I suspect it will require a closed session. But I just mentioned that because I have discussed it with you privately, as with the Admiral, and it is more than just a talking point with me. Secretary GATES. Well, we understand that fully, Senator, and it is with us as well. Senator LEAHY. Thank you. Secretary GATES. And I would just add one more point to the earlier point you made. There is no doubt that these wars have cost the United States, the American taxpayers a lot of money—as the chairman said at the outset, close to $1 trillion. That said, in terms of our international competitiveness, in terms of our overall economy, it is worth keeping the perspective that, at about 4 percent to 4.5 percent of gross domestic product (GDP), we are spending less on defense than during any other war time in our history. And it is a level that certainly is sustainable. Chairman INOUYE [presiding]. Thank you very much, Mr. Sec- retary. Senator Murray. Senator MURRAY. Mr. Chairman, Senator Specter came in while I was voting and does have a previous commitment, and I agreed that he could go ahead of me, if that is all right with you. Chairman INOUYE. Fine. Oh, Senator Specter, yes? Senator SPECTER. Thank you, Mr. Chairman. IRAN TO DEVELOP NUCLEAR WEAPON Secretary Gates, an article in the New York Times on April 17 of this year quotes sources on a confidential memorandum written by you, according to the Times article, which broadened considerations on dealing with Iran’s efforts to develop a nuclear weapon, to contain that effort. General John Abizaid had, some time before, talked about containment as an option. And I think we would all vastly prefer not to see Iran develop a nuclear weapon—unacceptable to have that country have such a weapon. But there has been talk about alternative courses if those efforts are not successful. What would the broad parameters be should the option be considered for a containment policy? Secretary GATES. First of all, Senator Specter, I would tell you that, contrary to the news account, the memorandum that I did earlier this year did not discuss, either by name or in concept, anything about containment. And my answer to your question would be is that I think we have a strategy. Our view is that it is unacceptable for Iran to have nuclear weapons, and we are proceeding on that basis. 440

Senator SPECTER. Mr. Secretary, when you testified back on March 21 of this year, I propounded a series of four questions and asked that they be responded to for the record. And as yet, I have not had a response. ISRAELI-PALESTINIAN CONFLICT Let me ask you at this time, on one of the questions which I propounded, and that related to a statement by General Petraeus to the effect that the Israeli-Palestinian conflict foments anti-Amer- ican sentiment, due to a perception of U.S. favoritism toward Israel. And his comment embraced the idea that a failure to resolve the conflict had begun to imperil American lives, which is obviously a very serious consequence. What basis, if you know, did General Petraeus have for making that statement, or is there any indication that that statement is factually correct? Secretary GATES. First of all, if you haven’t received the answers to your questions from March, I apologize for that, and we will find out why. My recollection—and I would defer to the chairman because he may remember better than I do—I do not think that that is, in fact, what General Petraeus said. I think that our view is it is clear that a Middle East peace settlement between Israel and the Palestin- ians would enhance our diplomatic and other efforts in the region and would enhance our own security because that dispute is used by our adversaries against us. But I don’t know of any evidence that the failure to arrive at a Middle East peace solution has, in fact, put American military lives at risk. Admiral MULLEN. Nor do I, Senator. I think the Secretary has it exactly right. Senator SPECTER. Secretary Gates, in an interview with CNN back on April 29, 2009, you had commented that you thought our policy was sometimes too arrogant. And one of the concerns that I have had has been in dealing with Iran, we have never been able to establish really a dialogue. For some time, a number of Senators were trying to have some interparliamentary exchanges. In 2007, Senators Biden, Hagel, Dodd, and I wrote a letter to the parliamentarians in Iran and got back a response—that had been discussed with President Bush at that time, who had no objection—got back a response from the Ira- nians that they liked the tone of our letter but were not yet ready to talk. And the question I have, in line with your comment about U.S. arrogance, would be is there any way we might use what President Bush had talked about starting his administration, a little more humility? And I think President Obama has certainly withdrawn any effort to have preconditions, like stopping the enrichment of uranium before you talk about the subject. Any way to modify our attitude in our dealings with Iran, which might produce some better results? Secretary GATES. Senator, every United States President since the Iranian revolution has reached out to the Iranians. I was present at the first outreach in—at the end of October 1979 when Dr. Brzezinski met with the leadership of the Iranian Govern- 441 ment—the prime minister, defense minister, foreign minister. We basically said, ‘‘We accept your revolution. We are willing to work with you. We have a common foe to your north. We will sell you all the weapons that we had contracted to sell the shah.’’ And they said, ‘‘Give us the shah.’’ Three days later after that meeting, our Embassy was seized. And 2 weeks later, all three of those people were out of power. Every subsequent President has reached out to the Iranians, no President more sincerely and with greater effort than President Obama. This is one case where I don’t think—where I think that the arrogance, frankly, has been on the other side of the table, not on the American side of the table. Senator SPECTER. Senator Murray, thank you for yielding. Thank you, Mr. Secretary. Thank you, Mr. Chairman. Chairman INOUYE. Senator Murray. Senator MURRAY. Thank you very much, Mr. Chairman. And thanks to all of you testifying before the subcommittee today. Secretary Gates, I wanted to start with you because, as you well know, among many of the troops who are serving us in Afghanistan today, many are deployed from Fort Lewis in my home State. They are on the front lines with the 5/2 Stryker Brigade, for instance, and they have suffered tremendous losses this year. And with the increasing Taliban offensive operations every day, families across my State are picking up the paper almost every morning now and reading about more casualties. MARJAH I am committed to giving our servicemembers every resource they need to bring a quick and decisive end to the Taliban and the other insurgent forces. But I am very concerned about the increasing number of casualties, but also concerned about the reports that we haven’t solidified our gains in Marjah and southern Afghanistan despite the tremendous sacrifice by our servicemembers and their families. And I wanted to ask you today what you can share with us to provide assurance that Marjah and our operations in southern Af- ghanistan are a success. Secretary GATES. Well, let me address it and then ask the chairman to do so as well. First of all, we made very clear at the very outset, many months ago, that this summer would see increased casualties. As our military and our coalition partners move into areas that have been controlled by the Taliban for the last 2 or 3 years, it was inevitable that there would be increased casualties. Tragic, but inevitable. And we have warned about this from the very beginning. The reality is that the military operations in Marjah were successful, and a place that had been controlled by the Taliban for 2 years or more is no longer controlled by the Taliban. Getting the civilian coalition and Afghan forces in there, the civilian officials, building the development programs is moving forward, but it is moving slower than we originally anticipated. 442 So I would say that, as I indicated earlier, I think that we are moving in the right direction. I just met with General McChrystal in Brussels last week. And I would tell you the general view of all of the alliance defense ministers was that we are moving in the right direction. We do now have all of the elements for success in place. This is going to be a long and a hard fight. And General McChrystal is convinced—confident—that he will be able to show that we got the right strategy and that we are making progress by the end of this year. But this is not something where week to week or month to month you can be able to say, ‘‘We are moving the front forward.’’ That is not the kind of fight this is. Admiral MULLEN. Progress in Marjah, ma’am is slow and steady. And we see indicators all the time where bazaars are open where there were none before. And this, as the Secretary said, is a place that was run by the Taliban for the last several years. They are still there and intimidating, and they recognize that. Fundamentally, they have been displaced, but they certainly haven’t been defeated in that particular area. We see an increase in the number of teachers who are there. There are some 80 plus teachers where a few months ago there were none. Schools are open where they weren’t. And I don’t want to paint a rosy picture here. It is a very, very tough fight. But we see steady progress, an increase in the number of local government of Afghanistan employees from in the 40s a few weeks ago to over 60 now. So we recognize the significance of it. We recognize the challenge of it. And it is going to take some time. We see an expanded rule of law taking place there. It is very gradual. This is a very, very tough undertaking, and it is going to take some time. And I would not—— Senator MURRAY. Okay. Admiral MULLEN [continuing]. Though, ask routinely when will we be successful in Marjah specifically? And it is hard to say that, but all the indicators are moving in the right direction, as tough as it is. Senator MURRAY. I have another question for Secretary Gates, but I think all of us are watching this very closely, and especially those of us who are seeing this affecting our home States and the servicemembers that we represent. So we will stay in touch with you on that as well. I did want to ask you, Secretary Gates, about a topic you and I have discussed many times, and that is the tanker competition. You know my concern about the fact that the World Trade Organi- zation (WTO) has said that there were illegal trade distorting subsidies for the A330 Airbus frame. And I know we have had an exchange on this issue. But I just heard you say in your opening remarks that the Presi- dent would veto any appropriations with the C–17 funding. And I am very concerned, if this is awarded to Airbus, the KC–X, that we would have absolutely no wide-body military aircraft production left in our country, leaving us very vulnerable in the future. Does the DOD have any plans to address the potential loss of U.S. capability? 443

Secretary GATES. First of all, as I indicated in response to Sen- ator Bond earlier, we expect to have the C–17 with us for decades, probably 40 years or more. Senator MURRAY. In production? Secretary GATES. There is significant wide-body aircraft production capability in the United States, and we have more than enough time to adjust it to a military production line if we need to. Senator MURRAY. And the production capability and ongoing engineering design and manufacturing? Secretary GATES. Sure. I mean, if you have wide-body engineering and capability for civilian and commercial purposes, it can be adapted for military purposes. Senator MURRAY. My time is up, Mr. Chairman. Thank you. Chairman INOUYE. Thank you. Senator Cochran. Senator COCHRAN. Admiral Mullen, the Defense Department, I understand, has suggested that continuing the DDG 1000 destroyer program is essential to our national security interests. One of the reasons I understand for this is the determination that there is an important need in maintaining a national ship building capability. What suggestions do you have or strategies do you have that will address concerns about our ability to meet our current and a future national security needs in the area of ship building? SHIPS FOR NAVY Admiral MULLEN. Well, as I indicated in my opening statement, Senator Cochran, I think that being able to produce the number of ships that we need for our Navy is a critical imperative for our future security and that we have an industrial base that obviously supports that. And the only way in the many years that I have been involved in ship building in particular, the only way I have ever seen it come close to success is to reach that sort of strategic partnership that I indicated before between the industry, obviously you on the Hill, and the administration. And it has got to be affordable. I mean, one of the challenges that we had with the DDG 1000 program, like too many, is we started and the costs just absolutely skyrocketed, and it essentially does itself in. And I don’t know any other way to get at that except that kind of strategic partnership, which then together addresses the major challenges, both in acquisition, in transition from one ship class to another, the challenges that obviously exist in shipyards in your home State, as well as where we have additional shipyards. How do we inject the technology over time? How do we sustain that capability over time in what takes a long time to build as well as expected to be around for 30 to 40 years, depending on the ship that you are talking about? I think it is absolutely vital that we have that base. But it has got to be at an affordable level. NEW GOVERNMENT IN IRAQ Senator COCHRAN. Mr. Secretary, there are some political uncertainties surrounding the new government in Iraq. And we know 444 that there has been violence, and there probably will be more violence. My question is will the delays that are being observed in establishing a new government affect the drawdown of U.S. forces? Are we going to be forced by danger signs of instability to change our plans and strategy of how to deal with the situation there? Secretary GATES. The short answer, Senator Cochran, is no. The truth of the matter is the election trajectory in Iraq is basically going pretty much as had been predicted. We figured it would take several months for them to form a government after the election. An important hurdle in terms of General Odierno’s confidence was the certification of the election last week. The Council of Rep- resentatives convened this last Monday, and that begins the process of formation of the government. So the violence that we have seen has really been al-Qaeda in Iraq violence aimed at promoting or provoking sectarian conflict and sectarian violence. And one of the good news stories out of Iraq is that that effort on their part has completely failed. These guys are doing politics. And I would just say, coming out of the NATO summit—and I probably shouldn’t say this—but I was intrigued with the fact that we have a new Dutch Government in formation, and they anticipate that it is going to take about 4 months to put the Dutch Gov- ernment together. So, you know, these coalition governments aren’t too easy even in established countries. Senator COCHRAN. Admiral Mullen, what is your assessment of the Iraq security forces and their capability of effectively managing the security challenges? Admiral MULLEN. Maybe I could use just a vignette to speak to that, that recently when two of the top al-Qaeda leaders, al-Qaeda in Iraq leaders were killed, that is Iraqi security forces were very much involved in that. And every time I both either see or ask about this issue, they are in the lead. And there is a great confidence in particularly their ground forces. We are working to evolve their naval capability. We are working to evolve their aviation capability. But they have been particularly strong. What General Odierno will also speak to is he was taken back a little bit by the way they seized this requirement when we came out of the cities 1 year ago last June. Their country, a lot of pride in what they do, and they really have stepped up to it and made a difference. Senator COCHRAN. Thank you, Mr. Chairman. Chairman INOUYE. Thank you. Senator Dorgan. Senator DORGAN. Mr. Chairman, thank you very much. Welcome. SUPPLEMENTAL Mr. Secretary, Senator Cochran, I think, asked in his—rhetori- cally in his opening statement about the supplemental. I think we were told earlier that the supplemental had to be completed by Me- morial Day. It was, of course, not. I mean, the Senate has completed it. 445 But what is the date by which you are not able to make the payments you need to make in terms of getting the supplemental done? Secretary GATES. I had hoped that it would be done by Memorial Day. We begin to have to do stupid things if the supplemental isn’t passed by the Fourth of July recess. We will have to begin planning our—the money that we have in the overseas contingency fund for the Navy and the Marine Corps will begin to run out in July. We will then turn to O&M money in the base budget for them, causing us to disrupt other programs. The Army comes along a little behind that. And we reach a point—and so, we begin to have to do disruptive planning and disruptive actions beginning in July. We could reach a point in August, in early to mid August, where we actually could be in a position where the money that we have available to us in the base budget runs out, and we could have a situation where we are furloughing civilians and where we have active duty military we cannot pay. Senator DORGAN. Mr. Secretary, you mentioned a startling sta- tistic. You talked about, I think, the Joint Strike Fighter in a plant where it was taking 7 percent of the space in the plant, and the Government was being charged 80 percent of the overhead. Secretary GATES. Six percent of the floor space, 70 percent of the overhead. Senator DORGAN. I am sorry, 6 percent of the floor space, and yet you were being charged 70 percent of the overhead. How does that happen? I mean—and by the way, I appreciate and I think all Members of the Senate appreciate your deciding we are going to make people accountable for bad management practices, and we are going to incentivize and laud good management. But how did you find that out and then check it back and find out who on Earth made that decision? Secretary GATES. Unfortunately, Senator, I think there have been a lot of bad decisions along these lines in terms of contracting and in terms of our acquisition process. And so, the acquisition reform bill that was passed here and that the President signed into law is an important asset. But at the end of the day, what is really required is people who can execute a program efficiently and with a very sharp pencil for the taxpayer. I don’t think we have had a sharp enough pencil, and in some cases, I don’t think we have had sharp enough managers. I think we are trying to more professionalize our acquisition workforce now. We are substituting career civil servants who have these skills for contractors who, in many cases, have been doing it. But we just have to be a lot smarter and a lot tougher and a lot more effective in our execution of the programs, and as you suggested, and as I believe, and hold people accountable. Senator DORGAN. The work you are doing on contracting is so important. I mean, it is an inelegant term, but it is just, to use the term ‘‘dumb’’ for anyone who would say, ‘‘Yes, our program has 7 percent or 6 percent of the floor space, we are willing to ante up 80 percent or 70 percent of the—of the overhead.’’ I mean, that is 446 just dumb for somebody to do that. And I applaud what you are trying to do to establish accountability. I want to ask about Afghanistan because I am nervous and worried about that which has been written recently and I think also acknowledged by some—the persistent violence around Marjah, the issue of the Taliban in Kandahar, and General McChrystal saying that this is going to happen more slowly than we originally anticipated. And as I look at that, and I wonder, you know, what are the costs of that in terms of soldiers’ lives and money and so on, and then I also wonder, aside from Marjah and Kandahar, do we ever expect to control the tribal regions of Afghanistan? I mean, so as I look at that, I am becoming more and more nervous about the July 2011 date by which the President talked about bringing troops out. So give me your assessment. We are reading these things that seem less optimistic and seem to suggest things aren’t going as they expected. Secretary GATES. Let us both take a crack at it briefly. First of all, I think that we have—I think General McChrystal has finally put in place a strategy that can be successful in Afghan- istan. We have the assets arriving on the ground that will allow us to be successful. We still have a third of the troops yet to arrive that are part of the surge. So we are only a few months into the execution of the President’s new policy, and I must tell you, I have a certain sense of de´ja` vu because I was sitting here getting the same kind of questions about Iraq in June 2007, when we had just barely gotten the surge forces into Iraq at that point. This is not—this is not some kind of production program or something where you have—you know, you are going to meet these particular objectives this week and next week. This is—as the chairman was saying, this is a process. We think we have the right assets, we have the right strategy, we have the right leadership. And most of our allies and partners share our view that things are heading in the right direction and that we will be able to show clear progress and that we are on the right track by the end of this year. But this is not something where we do ourselves any favors by tearing ourselves up by the roots every week to see if we are growing. This is a process, and it is going to be long and hard, but we are headed in the right direction. MILITARY CAMPAIGN IN KANDAHAR Senator DORGAN. But, Mr. Secretary, I just wondered, I was actually quoting General McChrystal when he said this will ‘‘happen more slowly than we originally anticipated.’’ So—— Secretary GATES. Yes. And what he is talking about is the time, as we shape—what General McChrystal has also tried to make clear is this is not going to be a traditional military campaign in Kandahar. There is a huge political and economic component to this. And the shaping of the political environment, as they—as they had real success in doing before Marjah, is very important in Kandahar. And that is what he is talking about is going to take a little more time than he anticipated. 447

Admiral MULLEN. I would echo what the Secretary said, from what I have seen and certainly my interaction with General Petraeus and General McChrystal, Senator. And I mean, we all have angst about this, but we have got a tremendous leadership team. We have put the resources in, and it is a very, very difficult counterinsurgency. And as I said in my opening statement and I have said before, I think Kandahar is the center of gravity for this. I think we will know by the end of the year obviously where we are with respect to reversing the momentum, and that is one of the key objectives here. What I am concerned about, and I know people are focused on July 2011, we all are in a way, but we are not just not going to know until we get much closer to July 2011 how many troops and where they will come from, the pace and the place. And all of that is conditions based, and I think we have to remember that. Clearly, I think we will start thinning our lines, if you will, and moving our troops out, but we are just not going to know. And we haven’t gotten to July 2010 yet. So I share the angst. There is an awful lot of people focused on it. And we want to be as—and nobody more so than General McChrystal—as transparent with what is going on as possible. But it is not just a military issue. It is the economic piece, the governance piece, all those things, all of which we are shaping right now, particularly in Kandahar. Senator DORGAN. I thank you very much. Mr. Chairman, thank you. Chairman INOUYE. Thank you. Senator Feinstein. Senator FEINSTEIN. Thank you very much, Mr. Chairman. CHINA Mr. Secretary, thank you again for your service. I think you have been terrific, and I know how hard it is. So thank you very much. The question—I wanted to ask two, one on Afghanistan and one on China. Let me take the China first. Things back here are Euro-centric. Out West, we look West. And for 30 years now, I have been going back and forth to China and trying to do what I can to build and improve a relationship. I just spent the last week there meeting with a lot of the leadership and came away with a very different view of what is happening, and I wanted to talk with you about it. I shared with them my dismay over your being turned down to meet with your counterpart. And what came back were arms sales to Taiwan. Now the impression I had from our Government before I went was, well, the Chinese expect this, and they are not going to be very upset. In fact, they were very upset. And a way they have in showing it is a refusal of military-to-military contact, in my view, at a time when the Chinese military is expanding strategically in a very critical and concerning way. And I think that everything we do—we subscribe to the one China policy. Everything we do should be to minimize conflict in the straits. We met with President Ma Ying-jeou. He has had a very constructive relationship. He is about to sign an economic 448 framework agreement with the mainland. And I think there is the opportunity to consider where we go if this across-the-strait situation is stable. So my question to you is this. What significant action could China take to ease its military posture in the strait in a manner that was substantive enough for you to consider or reconsider the future arms sales to Taiwan, which are a substantial irritant and will continue to be a substantial irritant, in my view? Secretary GATES. First of all, Senator, one of the points that I made in Singapore with Chinese military leaders in the audience was that our arms sales to Taiwan are on the basis of the Taiwan Relations Act that was passed at the time of normalization in the late 1970s. I think that—and they have known that all along. And I was struck by an article in the local press in Singapore following that session. Somebody asked one of these Chinese generals or some Chinese general—may not have been one present—‘‘You guys have known about these sales for decades. Why all of a sud- den are you raising such a stink about them?’’ And this general’s response was, ‘‘We had to accept it when we were weak. We are no longer weak.’’ And the bottom line is the decision on Taiwan arms sales is fundamentally a political decision. It is a decision mandated by the Taiwan Relations Act, and it is a presidential decision. So this is not a decision that is up to the Department of Defense. It is a decision that is up to the political leadership of the United States in terms of what would be required in order to change our approach with respect to the execution of that law or change that law, if it is necessary. I don’t know whether that is required. But that is essentially a political decision, not one that we in DOD would take. But I would tell you the Chinese, even though the president of Taiwan has reached out and that relationship looks pretty stable— and we certainly applaud the growing links between Taiwan and the People’s Republic—another piece of that is the extraordinary Chinese deployment of all manner of cruise and ballistic missiles opposite Taiwan on the Chinese side of the strait. So that is a reality that goes along with the growing other links between the two. But as you say, our position, and I repeated it in Singapore, was we are opposed to the independence of Taiwan. We stick with the three communiques that have guided United States-Chinese relationships for the last 30 plus years, and we need to go forward. Senator FEINSTEIN. Perhaps some of this I should discuss with you privately, but in my meeting with some of the leadership, it was mentioned that China had offered to redeploy back. Now I understand the word ‘‘redeploy’’ isn’t ‘‘remove.’’ And I understand the nature of what is there and the number of troops. However, I think that the most important thing we can do right now is establish some military-to-military contact. And I discussed this with Admiral Willard, as a matter of fact as late as yesterday, and I think he thinks this way as well. So I would just leave that with you. I think it is extraordinarily important that we find a way that our top flag officers can communicate with their counterparts. Secretary GATES. Well, I would just say, Senator, that I also believe those contacts are necessary, and not just sort of ship visits 449 and the uniformed officers talking with one another, but from a policy standpoint and from a strategy standpoint. The point I have made, and my whole speech in Singapore, a good part of it, was about the importance of military-to-military relationships between our two countries. Because in my experience with the Soviet Union, I don’t know if the strategic arms talks ever really achieved much arms control. But the one thing I do know is that over a 25-year period, we gained a very good understanding of each other’s approach and strategy when it came to nuclear weapons, nuclear strategy, and so on. And I believe deeply that it helped avoid miscalculations and misunderstandings. I have no interest in a military-to-military relationship where we basically get together and sing ‘‘Kumbayah.’’ Senator FEINSTEIN. That is right. Secretary GATES. But I think that having a relationship where we can talk about things that are really potentially dangerous in our relationship has all kinds of merit, and I am a strong proponent of contacts with the Chinese military for that kind of a dialogue. Senator FEINSTEIN. Thank you. I am pleased to hear that. I think my time is up. Thank you. Chairman INOUYE. Thank you. Senator Bennett. Senator BENNETT. Thank you very much, Mr. Chairman. Mr. Secretary and Mr. Chairman, Admiral, thank you for all of your service and all of the good work you do and all of the hard work you do. SOLID ROCKET MOTORS I have listened with great interest to the questions of my colleagues, and they have addressed all of the major issues. And so, I am going to be a little bit parochial. Senator Murray talked about tankers, and Senator Cochran talked about ships. It will come as no surprise that I am going to talk to you about solid rocket motors. And you are well aware that many of us are concerned with the solid rocket motor industrial base and the importance of sustaining that. And in the Nuclear Posture Review (NPR), I understand the Quadrennial Defense Review, recently published national security strategy, testimonies, and so on, you all underscored the need for the capabilities and the stability of systems that rely on solid rocket motors and a robust production industry. Unfortunately, the administration’s budget seems determined to go in the other way, the other direction, and we will not only lose the industry, we will lose the skills that go with it. The industrial base is one thing, but when you really are talking about rocket scientists, you lose them, and they go elsewhere. And it would be impossible to reconstruct that. So, last year, the Congress directed the Department to review and establish a plan to sustain the solid rocket industrial base, and the plan was to be due June 1. June 1 has come and gone. I understand an interim report is still in the development and that the De- partment is working toward delivery of a final plan ‘‘no earlier than the end of this fiscal year.’’ 450 If I can take you to today’s newspapers, they are talking about a continuing resolution at the end of this year, to be followed at some undetermined moment an omnibus bill, and this creates great uncertainty with respect to the solid rocket folks. So, in the absence of an official recommendation regarding the delivery of a solid rocket motor industrial base sustainment plan, do you have any recommendations that you could offer now or anything you could share with us as to the thoughts the Department may have in this area? Secretary GATES. Let me ask the Admiral if he has any—anything on this. I would tell you that I am not aware of the status of this report and not in a position to provide any recommendations, frankly, because I just don’t know. But I am happy to go find out why this report is overdue and see if we can’t bring it to conclusion. Senator BENNETT. I am less concerned with the June 1 date than I am with the idea that all we will have is an interim report by the end of the fiscal year. And this subcommittee is going to have to take action before the end of the fiscal year because it may very well be that the Defense appropriations bill becomes the only one that escapes the omnibus and passes on its own. Secretary GATES. No, I will commit to you that we will—— Senator BENNETT. I know the chairman hopes that is not the case and I hope it is not the case with him, but there is always that possibility. Secretary GATES. What I can commit to you is to try and get this report and its recommendations to you so you can make some timely decisions. Senator BENNETT. Okay. Well—— Admiral MULLEN. Senator, actually, I don’t—I don’t have any more background at this point than the Secretary. I would have to go do some homework. Senator BENNETT. All right. That is fine. Most disturbing to me and others who share my concern about this—this is not strictly a Utah parochial issue—is the lack of evidence—it is a complete lack of evidence—of any coordination between the National Aeronautics and Space Administration (NASA) and the Pentagon before undertaking the actions to basically kill this industry. And do you have any reaction to that statement? We have discussed this in hearings before, but are you aware of anything that has been raised with the Department of Defense on the part of NASA, as they have decided unilaterally to shut down the creation of solid rocket motors? Secretary GATES. I am just not aware of whether or how much coordination there was with us, Senator, but I can certainly get an answer for you. [The information follows:] In response to the Congressional direction in section 1078 of the National Defense Authorization Act for Fiscal Year 2010, Public Law 111–84, the Department has reached across all SRM stakeholders—including NASA—to ensure all potential industrial base issues regarding SRMs are identified and plans are put in place for their resolution. To this end, the Under Secretary of Defense for Acquisition, Tech- nology and Logistics (AT&L) established a three-tiered InterAgency Task Force (IATF). The IATF is co-chaired by the Department and NASA and has members from the Office of the Secretary of Defense (OSD), NASA, Missile Defense Agency, 451

Air Force, Navy, and Army. The IATF has met 12 times since the first meeting on November 6, 2009. The next meeting is scheduled for August 9, 2010. As part of a government-wide effort, the IATF discussed various human flight options NASA was considering. Representatives from NASA have actively participated in the IATF; attending meetings and contractor site visits, providing SRM presentations to team members, and developing a range of options for the Department to consider as it works to sustain the SRM industrial base. Senator BENNETT. I think the implications for this are very serious. NASA, I think, is making a mistake. For NASA purposes, I think the absence of solid rocket motors in NASA is going to raise NASA’s costs, going to destroy the space program in a number of areas where I think it is important. But to go ahead on that decision without even talking to the Pen- tagon, in terms of the implications for Minuteman and other areas in the Defense Department where you are dependent on a solid rocket motor, borders on the irresponsible. So anything you could share with us I would very much appreciate. Thank you, Mr. Chairman. Chairman INOUYE. Thank you. Senator Feinstein. NATIONAL INTERDICTION UNIT Senator FEINSTEIN. Thank you very much, Mr. Chairman, for allowing me this extra question. I very much appreciate it. Secretary Gates, I am chairman of something called the Senate International Caucus—the Senate Caucus on International Drug Control. We call it the Drug Caucus. And we are about to put out a report on Afghanistan. I am very concerned that the Taliban is on its way to becoming a narco-cartel. And I won’t go—I can make the argument here. I am not going to make it here. It will be in our report. But I want to ask you about one specific thing. There are specially vetted units supported by United States personnel that have proven to be very effective at conducting counternarcotics operations all around the world. At this time, there are only 288 members of the national interdiction unit of the Afghan counternarcotics police that have been vetted and work directly with United States personnel. Program managers have told the staff of our caucus that an additional 250 vetted officers are needed for the unit, based on the scope of the drug problem in Afghanistan. And this would maximize the ratio of United States men to Afghan officers at the current staffing levels. The contract for training the Afghan counternarcotics police is administered by the Department of Defense. My question to you is would you take a look at it and take a look at the possibility of adding 250 officers for this national interdiction unit? Secretary GATES. Sure, we will take a look at it. Senator FEINSTEIN. I appreciate that. Thank you. That is my question. Thank you, Mr. Chairman. Chairman INOUYE. Thank you very much. I have a question, Mr. Secretary, that has been festering in this body. Up until World War II, we had senior military officials with a full array of medals, with enemy generals and admirals in full 452 array, signing documents to end a war. That is how we ended wars. Everything ceased. At what point could you say today the war is over, that we can leave? Secretary GATES. I think that the war in Afghanistan will end much as the war in Iraq has ended. And that is with a gradual transition from our being in the middle—our being in the military lead while the Iraqi security forces were growing, then partnering, then the Iraqis in the lead and our drawing back to tactical overwatch, and then strategic overwatch, and now an advisory and assist role, at the same time that the political system, starting fresh, was being created and maturing. FOCUS ON YEMEN AND SOMALIA And I think what you will see is the same kind of a gradual transition to where the Afghans are in the lead in the security arena. That is what we are talking about when we talk about when we begin a process of transition to Afghan control in these provinces. We are already talking about which ones of those will happen, and can we do some of them beginning in—toward the end of the year or early next year? So as we did it province by province in Iraq, I suspect that that is the way it will happen in Afghanistan as well. And I think however much people may debate how we got into Iraq, the outcome has ended up, at this point at least, being more positive than anybody could have dreamed 3 years ago. Chairman INOUYE. I thank you very much. May I ask another question? Secretary GATES. I am cautioned to say the Iraq war is ending, not has ended. Chairman INOUYE. I realize that no one can predict the signing of the document. But, Admiral Mullen, there is a place called So- malia that most Americans cannot point out on the map. However, press reports that it is becoming a safe haven for al-Qaeda and other foreign fighters, training ground, et cetera. Are we going to get rid of them? Admiral MULLEN. Chairman, for the last couple of years, I have talked about concerns with respect to growing safe havens and, in fact, an awful lot of focus on Yemen and Somalia specifically. And there is an al-Qaeda presence specifically in Yemen right now, which is very dangerous and growing and needs to continue to be addressed. There is certainly a terrorist safe haven in Somalia. And in terms of civility, it is a country that certainly if not a failed state, is borderline failed state. And in fact, there are camps where terrorists are trained in Somalia that we need to all be concerned about. So I am concerned about the fact that Somalia continues to fes- ter, to use your word, in a very negative way, a government that is struggling to control it, under assault, quite frankly, from organizations that are terrorist based, and continue to be the home for the piracy network clearly, which is a challenge in that part of the world. So I am extremely concerned about that and its continued— ability to continue to grow in the future. 453 The other place where there is longer-term potential is in northern Africa, in the Pan Sahel, where al-Qaeda has a very strong link as well. And so, while we focus on Afghanistan and Pakistan, which is where al-Qaeda leadership resides, it is really that network which is still extremely dangerous and intent on executing the kinds of potential attacks that we saw in Detroit at Christmas and recently in Times Square. Chairman INOUYE. Senator Cochran, do you have any questions? Senator COCHRAN. I have no further questions. Chairman INOUYE. Then, Mr. Secretary and Admiral Mullen, thank you for your testimony this morning and for your—— Secretary GATES. Mr. Chairman? Chairman INOUYE. Yes? Secretary GATES. At the risk of prolonging the hearing, could I take just a moment to address the two questions that you put to me in your opening statement very quickly? Chairman INOUYE. Yes, sir. Secretary GATES. First of all, one of the frustrations that I have had ever since taking this job has been that the Department of De- fense is organized and structured to plan for war, but not wage war. And the only way I have found that I have been able to get the kind of urgent action to create the MRAPs; to get the additional intelligence, surveillance, and reconnaissance work; to do the counter-improvised explosive device (IED) effort has been by pulling together these ad hoc groups, as you have described them, these task forces, where I chair them and essentially have all of the senior players, both uniformed and civilian, at the table, and to be able to force the kind of rapid action that has been necessary to support those in the field. In several of these areas, I think that the work has reached a point where I think I can begin to take actions to begin to return these efforts to where they would traditionally have a bureaucratic home. The MRAP Task Force, the ISR Task Force, the Counter- IED Task Force that is co-chaired by General Paxton and Under Secretary Carter never was intended to last more than another 2 or 3 months from now. So I think in at least three of these areas that we will be able to move back toward the traditional structures in the Department of Defense. But long term, it is a serious issue for the Department and, frankly, one that I have not yet found the answer to in terms of how to get urgent action in an area supporting men and women in combat today that ranges across the entirety of the Department, both uniformed and civilian, and all the different Defense agencies. With respect to the balance between future threats from near- peers and others, as opposed to our focus on irregular warfare, I would just remind the subcommittee that if you took a broad look at our budget, about 50 percent of our procurement budget is for what I would call long-term modernization programs to deal with near-peer countries, about 40 percent is dual purpose, like C–17s and other things we will use no matter what kind of conflict we are in, and about 10 percent has actually been for irregular or the kind of asymmetric warfare we have been talking about. So I think we have a very large number of programs in this budget that are aimed—and in fact, half of the procurement budget 454 roughly that are aimed at the longer term, more sophisticated threats that this country will face in the future. Thanks for the extra couple of minutes. Chairman INOUYE. If I may follow up Senator Feinstein? Press reports, as you have indicated, show that the Chinese have been advancing their cyber activities, their cruise missiles. Are we concerned? Secretary GATES. We are very concerned, Mr. Chairman. The growing capability of the Chinese with anti-ship cruise and ballistic missiles is a real concern for our Navy and for us. The cyber capability is very important. The anti-satellite capability and potential space-denial capabilities are of concern to us. So there are a number of areas of Chinese modernization that are of concern to us. And frankly, this is one of the reasons why I think having a strategic dialogue with them to try and gain some understanding and have some frank talks about these concerns has merit. Maybe the Admiral would like to add a word? Admiral MULLEN. Well, sir, I am right there. I am increasingly concerned. It is increasingly opaque, and these dialogues are absolutely critical to try to understand each other. Each time—at least from my perspective, each time it gets turned off, it gets turned off by the Chinese, and then we will go through a period of time where we have no relationship. The Secretary talked earlier about Iran and his experience in 1979. And what that has led to is no relationship with a country for over 30 years, and look where we are. And so, if I use that as a model, that is certainly not one that we can afford as a country or as a military with China as China continues to grow. The peaceful rise of China, China as a global power, all those things make sense to me. What doesn’t make sense to me is the fact that they won’t engage, and specifically that their military won’t engage.

ADDITIONAL COMMITTEE QUESTIONS

Chairman INOUYE. Well, once again, I thank you very much. And I thank you for your service to our Nation. And we look forward to working with you in the coming months as we continue our review of the budget. And as you conduct your internal analysis of military requirements, I would like to encourage you to share them with us so that we can be in step with you as we begin our work for the following fiscal year. As you know, we are having a few problems with the House on the supplemental, but I think we can resolve them. I hope so. [The following questions were not asked at the hearing, but were submitted to the Department of response subsequent to the hearing:] 455

QUESTIONS SUBMITTED TO ROBERT M. GATES

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

SOMALIA Question. Secretary Gates, recent press reports have highlighted the growing presence and influence of foreign fighters and al-Qaeda in Somalia’s Islamist al-Shabab group. How would you assess the threat posed by these groups to western interests in East Africa? Is Somalia becoming the ultimate safe haven for al-Qaeda and foreign fighters? Answer. Since mid-2008, several hundred of foreign fighters of various nationalities have entered Somalia to join al-Shabaab’s ranks, although exact numbers and nationalities of foreign fighters in Somalia remain unclear. The recent June 2010 arrest of two U.S. citizens allegedly on their way to Somalia to join al-Shabaab, and the July 2010 terrorist attack in Uganda for which al-Shabaab took credit further underscore the alarming nature of this trend. The influx of foreigners to Somalia could extend al-Shabaab’s global reach, posing an increased transnational threat to U.S. and Western interests in the region. Moreover, cooperation between al-Shabaab and al-Qaida senior leadership could enhance the potential of a formal merger between the two groups, increasing the threat of the existing terrorist safe haven in Somalia. Reports indicate that al-Qaida senior leadership likely views Somalia as an important arena for jihad and an established safe haven from which to launch transnational attacks, factors likely providing al-Qaida with motivation to strengthen its relationship with al-Shabaab. Moreover, public releases by al-Qaida and al- Shabaab indicate increased cooperation between the two groups, which al-Qaida intends to leverage to establish a base of operations. As I have remarked before, in the decades to come, the most lethal threats to U.S. safety and security are likely to emanate from states that cannot adequately govern themselves or secure their own territory. Dealing with such fractured or failing states, such as Somalia, is, in many ways, the main security challenge of our time because they can incubate transnational security threats. In places like Somalia, where al-Qaida aims to establish a foothold and a safehaven, we must confront it with persistent pressure and strong partnerships. The United States is a committed partner to the African Union Mission in Somalia and the Somali Transitional Fed- eral Government in support of the Djibouti Peace Process. Our objective for Somalia is to work with other U.S. Government departments and agencies to enhance stability, peace, and prosperity in Somalia and, by extension, in the East Africa region.

CHINA Question. Secretary Gates, do you see China as a reliable partner in the region, and are they willing to assist us in dealing with the tensions on the Korean peninsula? Answer. We have appreciated China’s willingness to cooperate and partner with the international community on regional security matters including on the Korean peninsula. For example, China supported the United Nations Security Council in crafting United Nations Security Council Resolution 1874, and China has served as the chair of the Six-Party Talks process. We continue to urge China to work with the international community to address North Korea’s proliferation activity and its provocative behavior.

IRIDIUM CONSTELLATION REPLENISHMENT Question. Secretary Gates, I have recently learned of the announcement of the intent of Iridium LLC to award a contract to the French satellite manufacturer Thales, to replenish its current 72 communication satellite constellation. I am concerned over the potential national security issues that could result from the Depart- ment’s continued use of a communications system that will now be built by a foreign supplier. What risk mitigation plans are in place that will ensure that U.S. military user locations are not compromised or communications will be more susceptible to intercept? What are the technology transfer issues associated with backward compatibility requirements with the present system? Has a review been conducted on the impact and implications of the Department’s use of an Iridium satellite communications system that is built by a foreign source? Answer. The Defense Information Systems Agency’s (DISA) Enhanced Mobile Sat- ellite Services (EMSS) Program was established to provide global, secure, handheld mobile satellite communications services leveraging the Iridium constellation. DOD owns and operates its own Iridium earth station in order to ensure that U.S. mili- 456 tary user locations and communications are protected. DOD would continue to operate this earth station as Iridium updates its constellation. Iridium Communications, Inc. has announced its intentions to develop and launch the next generation Iridium constellation called Iridium NEXT. The new technologies and capabilities developed in Iridium NEXT will include new technologies for the terrestrial infrastructure. The EMSS Program Management Office has requested capital investment funding for fiscal year 2010–15 to migrate the EMSS Gateway from the existing infrastructure to the Iridium NEXT infrastructure. As these upgrades are being executed, the DISA Field Security Office, working closely with the EMSS Program and EMSS Gateway personnel, will ensure that the existing security posture of the EMSS Gateway will not be compromised during the transition. Iridium NEXT is to be a fully backward compatible system. As the original constellation was commercially developed, there are no military unique features embedded in the existing Iridium constellation or in the Iridium terrestrial equipment. As a result, no technology transfer issues will exist in the migration of the infrastructure. The military unique systems that reside in the gateway will be migrated as required to ensure that they will continue to provide the services and protections that exist today, but the development of those systems exist outside Iridium’s developmental processes. No formal review has been conducted on the impact and implications of the De- partment’s use of a Thales constructed Iridium NEXT. The development of the Irid- ium NEXT satellites by a foreign country does introduce some security concerns. Currently, there are no U.S. Government agencies that have committed to hosting payloads on Iridium NEXT satellites. If the Government’s investment in Iridium increases, the appropriate studies will be conducted by the responsible agencies. Iridium Communications’ award to Thales requires Thales to include a U.S. aerospace firm to fulfill the role of the spacecraft integrator. All indications are that Thales will most likely partner with Ball Aerospace as its spacecraft integrator. Ball Aerospace, a U.S. aerospace firm based in Boulder, Colorado, will be responsible to receive, integrate, and maintain custody of any classified or ITAR-sensitive components up to the launch of the satellite vehicles. These components include telemetry encryption/decryption equipment and any classified or sensitive hosted payload components. Ball has a long history of developing classified spacecraft and payloads for the U.S. Government and has extensive facilities capable of handling classified equipment. Additionally, key on-board processor and spacecraft software will be developed by U.S. firms and will likely draw on legacy software from the current Iridium system. The teaming arrangement with Ball as the spacecraft integrator as well as keeping the critical systems and software development within the United States will provide a program structure that provides the necessary level of security and mission assurance.

IMPACT OF PROGRAM TERMINATIONS Question. These are not the only examples of terminated programs generating new, costly follow-on programs. This year, you announced the termination of the De- fense Integrated Military Human Resources System, yet the Services are already requesting over $170 million to continue that program. Mr. Secretary, what real cost savings have been generated given that terminated programs are being replaced by new, more costly ones? Answer. The Defense Integrated Military Human Resources System (DIMHRS) program was recommended for cancellation as part of the President’s fiscal year 2011 budget request due to cost overruns and performance concerns. Over $500 million had been spent over more than 10 years with little results. The program, however, was not recommended for cancellation because it was unneeded, but rather because it was underperforming and too costly. The requirement for modern military personnel and pay systems to replace over 90 legacy systems remains, and will be fulfilled by Service-level programs using the DIMHRS core software to the maximum extent practical. The Department considers Service-level programs, rather than a single Department-wide solution, to be the best balance of cost, performance, and schedule. This includes the Department’s concern with balancing near-term needs with long-term costs over the lifecycle of a program. Reforming how and what the Department buys continues to be a centerpiece of our nation’s defense strategy. The efficiency initiative the Department is pursuing, particularly the portions of that initiative directed at procuring more affordable products and buying services more efficiently, is specifically intended to ensure that terminated programs are not replaced by ones that are more expensive. 457

Question. Mr. Secretary, a key driver of costs in major weapons programs is poor management of program requirements. What measures are you instituting to avoid requirements creep? Answer. In the early phases of acquisition programs, the Department is addressing requirement overreach by subjecting each major program to a Materiel Develop- ment Decision before Milestone A, which will ensure early on that programs are based on approved requirements and a rigorous assessment of alternatives. Further- more, through competitive prototyping and preliminary design reviews before Mile- stone B, technical risks will be reduced before progressing to the more costly phases. Consistent with section 814 of the Duncan Hunter National Defense Authoriza- tion Act for Fiscal Year 2009, DOD acquisition policy also requires the Acquisition Executive of each DOD Component to establish and chair a Configuration Steering Board (CSB) with broad executive membership from the office of the USD (Acquisi- tion, Technology and Logistics) and the Joint Staff. CSB’s are required to meet at least annually to review all requirements changes for ACAT 1 and 1A programs in development that have the potential to result in cost and schedule impacts on the program. Such changes will generally be rejected, deferring them to future blocks or increments. On a roughly annual basis, program managers and program executive offices are also required to identify and propose descoping options to the CSB that reduce program cost or moderate requirements. This policy has been actively implemented at the component level. At each stage of the acquisition process for major acquisition programs, requirements are reviewed by both the Joint Staff and the Defense Acquisition Executive to ensure that requirements creep has not resulted in excessive costs.

SOMALIA Question. Secretary Gates, the conflict in Somalia has encouraged many foreign fighters to join the militant Islamist factions attempting to overthrow the inter- nationally backed Somali Transitional Federal Government (TFG). These foreign fighters seem to be mostly ethnic Somali e´migre´s living in Western countries, raising fears that some may return to their homes and carry out terrorist attacks. There are also public estimates of approximately 200 foreign fighters from Afghanistan, Pakistan, Iraq and Saudi Arabia, the most dangerous of whom are teaching bomb- making and other small arms tactics to recruits in camps across southern Somalia. Would you like to comment? Answer. We are concerned about the presence of foreign fighters in Somalia. Since mid-2008, open-source reporting reveals that foreign fighters of various nationalities, including individuals from European and North American countries, have entered Somalia to join al-Shabaab’s ranks. Although the exact numbers and nationalities of foreign fighters in Somalia remain unclear, reports indicate that several hundred foreign recruits have come to Somalia to support al-Shabaab and other Is- lamic groups since mid-2008. Foreign fighters threaten the Transitional Federal Government and the African Union Mission in Somalia and undermine their efforts to reach out to all peaceful elements of Somali society and build an inclusive reconciliation process for a stable, peaceful, and sovereign Somalia. The prevalence of foreign fighters in Somalia threatens not just the Horn of Africa, but countries around the world, as these fighters can return to their home countries to radicalize and recruit others to fight in Somalia or engage in worldwide terrorist activities. The July 11, 2010 terrorist attack in Uganda, for which al-Shabaab took credit, further underscores this threat.

DEFENSE DEPARTMENT SPENDING Question. Secretary Gates, since the attacks of September 11, 2001, the base budget authority for the Department of Defense has nearly doubled. Your recent statements in the press have indicated that military spending should expect closer, harsher scrutiny, and that real reform is needed in the way the Defense Depart- ment does business and spends taxpayer dollars. Your fiscal year 2010 budget request began the reform effort by hiring more civilian government employees to replace full-time contractors. Aside from investment and modernization efforts, please explain other major reform initiatives you are now considering and how those will translate into lower costs for the Department of Defense. Secretary Gates, you have been quoted in recent speeches that overhead within the Department of Defense is ripe for scrutiny. Please explain specific adjustments that could be made in this area to create savings in the budget. Answer. In recognition of the nation’s difficult economic situation, I have asked the Defense Department to take a hard, unsparing look at how we operate; and I am seeking to redirect the savings to provide the resources needed for force struc- 458 ture and modernization. I directed the Department to focus on headquarters and administrative functions, support activities, and other overhead activities. The Depart- ment should become a smarter buyer; therefore, we are taking a hard look at how we contract for goods and services. As I noted in my opening statement, I believe the current DOD topline is the minimum needed to sustain a military at war. What I am looking for is reduced costs in the ‘‘tail’’ portion of our budget in order to ensure that there are adequate resources in the ‘‘tooth’’ portion of the budget. The De- partment’s Components are now wrestling with this challenge as they build their fiscal year 2012–2016 programs. You will see the results in the fiscal year 2012 budget request.

TEMPORARY TASK FORCES Question. It is hard to understand why we seem to be moving in the opposite direction of your assessment last year. What is being done to exercise control and limit the growth of these task forces, and to permanently integrate them into the Department? Secretary Gates, what is your view on JIEDDO undertaking long term development projects? Shouldn’t these activities reside within the Military Services? Answer. In February 2006, the Office of the Secretary of Defense (OSD) transitioned the Joint Improvised Explosive Device (IED) Defeat Task Force by establishing the Joint IED Defeat Organization (JIEDDO) as an enduring, jointly manned activity within the Department of Defense (DOD). JIEDDO has been tasked with one critical purpose: to rapidly provide counter-IED (C–IED) capability in support of COCOMs to enable defeat of the IED as a strategic weapon of influence, and JIEDDO manpower resources have grown to meet this purpose. In order to comprehensively address the increasing significance of the IED as a weapon of strategic influence, JIEDDO developed tenants designed to address specific aspects of the threat: Attack the Network (AtN); Defeat the Device (DtD); and Train the Force (TtF). JIEDDO’s personnel resources increased to drive innovation with JIEDDO partners and stakeholders to develop and field effective material and non-material C–IED capabilities. The growth in personnel requirements has been necessary to support the development and procurement of technology, evolution and establishment of operational concepts, wide dissemination of lessons learned, and the delivery of training and training products in order to ensure speedy delivery of C–IED capabilities where it counts most—into the hands of the warfighter. The pace of JIEDDO organizational growth has been commensurate with the effort necessary to rapidly and effectively counter the substantial use of this weapon—rapid, effective and efficient responses have required increased personnel numbers to maintain the necessary speed at which solutions can be delivered. JIEDDO is currently in the process of streamlining its efforts to better respond to requirements for support coming from COCOMs. As significant force adjustments are being made across key theaters of operation, the use of IEDs have not waned. In fact, JIEDDO’s mission requirements have increased in Afghanistan and JIEDDO’s personnel levels will be a reflection of the C–IED demands coming from theater. We agree that long term S&T efforts should reside in the Department and the Military Services. JIEDDO’s goal for development efforts is 24 months. JIEDDO has reevaluated its R&D portfolio and given new guidance to their technical staff regarding this issue. JIEDDO’s subject matter experts assess each new proposed effort in depth to ensure that it is executable in this timeframe. Subject matter experts from across DOD, DOE, and other research organizations provide assistance to JIEDDO as needed during this vetting process. If an ongoing JIEDDO effort cannot meet this goal then it is evaluated to determine whether it should be terminated or continued. This determination is based on several factors including: progress made, potential value added to the counter IED fight, probability of success, likelihood of it being deployed and integrated if successful, etc. Recently, DDR&E and JIEDDO established a Technology Focus Team (TFT) to coordinate counter-IED R&D efforts throughout the Department and develop a strategy for long term counter-IED S&T. The TFT is co-chaired by DDR&E and JIEDDO and includes representatives from the Services, DARPA, and DTRA. The Depart- ment of Homeland Security also participates as an observer. The Military Services are responsible for executing the long term S&T strategy. JIEDDO adds value to the DOD portfolio by focusing the Department’s efforts in solving the most urgent needs and ensuring the relevance of our S&T efforts to the Counter-IED fight. To do this, JIEDDO will maintain a cadre of scientists and engineers fully dedicated to understanding and countering the IED threat. This team will concentrate in the most immediate war fighting problems and accelerate the de- 459 velopment of the most promising solutions. To facilitate cross pollination and engage the best and the brightest, the JIEDDO S&T team is augmented by scientists from across the DOD, the national labs, and other research organizations as needed.

HEALTHCARE COSTS Question. Secretary Gates, you have spoken recently about skyrocketing personnel costs that are ‘‘eating us alive’’. This has caused concern among service members and their families and several military and veterans advocacy groups. Could you please detail how healthcare costs impact the Department’s budget, and how you plan to reduce them? Answer. Over the past decade, healthcare costs have grown substantially across the nation, and Military Health System (MHS) costs have been no exception. MHS costs have more than doubled between fiscal year 2001 ($19 billion) and fiscal year 2009 ($45 billion) and are projected to continue to increase 5 to 7 percent through fiscal year 2015. At this growth rate, MHS costs will exceed $64 billion by fiscal year 2015. DOD is evaluating numerous proposals to make the system more efficient, from better supply management to getting better prices for healthcare services. In order for the Department to reduce healthcare costs, I believe one of the cost saving measures we need to take a fresh look at is the cost sharing structure for the TRICARE benefit plans. Enrollment fees for the TRICARE Prime program have not been modified since its inception in 1995. As of 2009, average out-of-pocket cost for a family of three covered by TRICARE Prime was $1,375 per year—compared to $3,430 per year on average for a family of three covered under the Federal Employee Health Benefit Plan’s Health Maintenance Organization (Kaiser). I look forward to working with members of Congress to devise a cost sharing arrangement that is both fair and reasonable.

QUESTION SUBMITTED BY SENATOR PATRICK J. LEAHY Question. Mr. Secretary, would you please elaborate on your vocal opposition to the Joint Strike Fighter alternate engine? While you have described this as a cost- savings issue, analyses by GAO and others show that either choice—to keep or get rid of the alternate engine—will probably be cost-neutral over the life of the F–35 program. But having an alternate engine will prevent a single point of failure for the F–35, which will be very important when the plane comprises 95 percent of our strike aircraft fleet. Why choose to drastically increase risk for the F–35 for little or no money saved when all is said and done? Answer. The Department has consistently emphasized its opposition to the Joint Strike Fighter (JSF) extra engine because continued funding of the F136 would divert funds from important defense needs. In the middle of two wars, the Depart- ment has other higher priority uses for $2.9 billion, the amount that would be required to take the extra engine to full competition. Furthermore, there is no guarantee that having two engines will create enough long-term savings to outweigh the significant near-term investment. The Department does not consider a single source engine for the F–35 to be a ‘‘drastic’’ increase in operational risk. The Department currently maintains two tactical aircraft programs, the F–22A and the F–18, each of which utilizes a single source engine provider. Both programs have enviable safety records, and the De- partment is satisfied with the engines for both programs. Over the years, significant advancements in engine design, testing, and production have enabled the Depart- ment to manage the risks associated with single engine systems without having to ground an entire fleet.

QUESTIONS SUBMITTED BY SENATOR DIANNE FEINSTEIN

OPERATION OF FIREFIGHTING AIRCRAFT Question. Last year, the House report accompanying the Defense Appropriations bill instructed your Department to analyze any legislative barriers that would impede the viability of expanding this joint operation program. Has your Department conducted this analysis and assessed the viability of expanding the joint operation of firefighting C–130 Js? Is your Department capable of jointly operating an additional 25 C–130s? Can you provide me with a date when the department expects to complete its analysis of expanding this program? 460

Answer. As requested by House Report 111–230, which accompanied H.R. 3326, the Department of Defense Appropriations bill for fiscal year 2010, the Department of Defense (i.e., the Office of the Assistant Secretary of Defense for Homeland De- fense and Americas’ Security Affairs, the Department of Defense Comptroller, the Office of the Assistant Secretary of Defense for Reserve Affairs, the Joint Staff, the U.S. Air Force, the National Guard Bureau, and the Air Force Reserve), the U.S. Forest Service (USFS), and the Department of the Interior (DOI) established an In- tegrated Working Group (IWG) for the purpose of assessing the viability of joint use Federal forest firefighting assets. The interim report was provided to Congress in April 2010. The final analysis and assessment are ongoing. We anticipate that the final report will be provided to Congress by August/September 2010. Question. Has the U.S. Forest Service officially approached the Department of De- fense to ask for assistance in procuring new or used C–130 Js to help fulfill the Service’s aerial firefighting needs? Answer. No. Question. What legislative, regulatory, and policy barriers prohibit the U.S. Forest Service from calling on the Guard’s C–130 Js to conduct initial attack on wildfires? In other words, why are the Guard’s C–130 Js always the last resources called upon to fight burning fires? Since these planes were purchased by the taxpayers, how can we make sure that they are used more appropriately? Answer. The U.S. Forest Service is one of eight Federal agencies (i.e., including also the Department of Defense, the Bureau of Land Management, the Bureau of Indian Affairs, the U.S. Fish and Wildlife Service, Fire and Aviation Management, the U.S. Fire Administration, and the National Weather Service) participating in the National Interagency Fire Center (NIFC). The NIFC, which is located in Boise, Idaho, is responsible for coordinating the mobilization of resources for wildland fires and ultimately makes the determination on what capabilities and resources to request and employ on an incident-by-incident basis. The NIFC maintains a contract for commercial air tanker services. The intent of this contract is to provide the Federal Government with large fixed-wing air tanker services, including the delivery of approved fire suppressant or retardant material on forest and range fires over all types of terrain throughout the United States. Ac- cording to interagency policy and guidance, the objective of the Modular Airborne Fire Fighting System (MAFFS) program is to provide an ‘‘emergency capability to supplement commercial air tankers on wildland fires’’ that may be ‘‘used as a reinforcement measure when contract air tankers are committed or not readily available.’’ When compared to other fixed and rotary-wing aircraft available for aerial fire suppression, MAFFS-equipped aircraft may not be the most appropriate for all contingencies that require a Federal response to wildfires. At the request of the NIFC, DOD has provided, on a reimbursable basis, a broad range of support to the NIFC over the years, including DOD aircraft and crews equipped with U.S. Forest Service- owned MAFFS; helicopters with water buckets; military ground firefighting crews (usually a Federal military or National Guard battalion); DOD civilian firefighters; engineering assets; fire engines; incident management team members; and incident assessment assets. When requested, such assets may assist in firefighting if they are available and not committed to executing DOD’s primary mission. DOD evalu- ates each request for assistance against six criteria for validating Defense Support of Civil Authorities: legality, lethality, risk, cost, appropriateness, and impact on readiness. Of note, although U.S. Forest Service requests for MAFFS support take prece- dence over State or international requests, the governors of California, North Caro- lina, and Wyoming may, after notifying the U.S. Forest Service, activate the Air Na- tional Guard airlift wings with MAFFS equipment and qualified crews assigned to their respective States for fires under State jurisdiction. Question. The National Guard 146th Airlift Wing in Point Mugu, California has been exemplary as they carry out the Guard’s firefighting assistance mission. It is my understanding that if they were provided an additional 2 to 4 C–130 Js that they would be eager to expand their firefighting role. I also understand that Guard wings from Nevada, Washington, and other States are eager to undertake this very important mission. Do you support the expansion of C–130 firefighting program in California and across the West? What can you do to help facilitate this expansion? Answer. The Federal agencies with primary responsibility for fighting wildfires are the U.S. Department of Agriculture and the Department of the Interior. The De- partment of Defense has a supporting role. In light of the need for DOD to identify over $100 billion in savings over the next 5 years to ensure DOD can execute its primary mission of protecting and defending the nation, procurement of additional DOD C–130s for firefighting is not a priority. 461

QUESTIONS SUBMITTED BY SENATOR PATTY MURRAY Question. Last May, Secretary Donley testified that the Air Force must consider Airbus as a viable competitor for the Tanker RFP. He stated that despite the WTO’s findings, Airbus still has the right to appeal WTO findings and cannot be legally excluded. What will be the consequences if Airbus is granted the Tanker contract and the WTO decision is sustained? Answer. The Department of Defense believes that full and open competition in source selection is the best way to obtain the best value for our military and the taxpayers. The source selection will be made based on the evaluation factors set forth in the RFP. Since the source selection process is ongoing, it would be inappro- priate to comment on it. There are two WTO Panel cases. The final WTO Panel Report on the United States case against the European Union (EU), i.e., France, Germany, Spain, and the United Kingdom, was published on June 30, 2010. An interim WTO Panel Report on the EU case against the United States for a different group of alleged subsidies is anticipated in September, and the final report is usually issued several months later. We have been advised by the Office of the U.S. Trade Representative (OUSTR) that there is an appeal process, and that it is expected to be beyond 2010, before the entire WTO process for determining the legal issues raised by any WTO-inconsistent subsidization is complete. In the event that there is a ruling against either Member, and the United States and the EU cannot settle the matter by themselves, then the WTO would determine the appropriate remedy. OUSTR is our national advocate for matters pertaining to WTO rules and procedures and represents U.S. interests in prosecution of, or defense against, charges of violations of such rules relative to any other Member of the WTO. Further, the KC–X contract will contain a unique contract clause to ensure that any economic impacts to the contractor resulting from the decisions of the WTO and the ultimate implementation of those decisions, will not affect the prices paid under the tanker contract. In this way the U.S. taxpayer is protected. Question. How will the DOD account for the harm already committed to the U.S. Aerospace industry? Answer. The parties of World Trade Organization (WTO) cases are bound by WTO rules. Under Article 23 of the Understanding on Rules and Procedures Governing the Settlement of Disputes (DSU), WTO Members seeking redress of an alleged violation must limit their recourse to, and abide by, the rules and procedures of the WTO. No Member has unilateral authority under the WTO to take retaliatory action. We have been advised by the Office of the U.S. Trade Representative that applicable appeal processes will continue beyond 2010. The appeal process must be complete before the WTO determines the appropriate remedy for any WTO-inconsistent subsidization. WTO remedies for actionable subsidies are forward looking in nature and not retaliatory for past subsidies. The WTO, not the United States alone, will determine what the appropriate remedy will be in these matters in the event that the United States and the EU cannot settle the matter by themselves. Question. I am concerned that you advocate shutting down the C–17 production line; however, if you award KC–X to Airbus, we would have no wide-body military aircraft in production in this country. How does the DOD plan to address this potential loss of U.S. capability? Answer. I share your concern with respect to future domestic industrial base capabilities. The Department continually assesses our nation’s industrial capabilities to include, among other things, a determination of the viability of any military- unique skills, processes, facilities or technologies. Ending production of the C–17 would not materially reduce the capability of the U.S. defense industrial base to supply future wide-body military aircraft. From a production standpoint, most parts of military aircraft rely on skills and facilities similar to those used in commercial aircraft manufacturing, so continued domestic production of 747, 767, 777, and 787 aircraft by Boeing and its subcontractors will maintain that capability along with continued production of components on Airbus’ A–330, A–340, A–350, and A–380 by American suppliers. From a design and development standpoint, the C–17 is well past its intensive design phase, and continued production will have little effect on American technical capabilities. Moreover, wide-body lift aircraft involve very little military-unique technology. Even as the Department begins shutting down the C– 17 production line, the technology and processes used by the wide-body civilian aircraft manufacturing base are readily available, mature, and directly applicable to those used by military airlift manufacturers, and American aerospace companies 462 have access to engineering talent that can develop the few military-unique aspects. I am confident that when the time comes in the future to produce additional military airlift, America’s aerospace industry will be able to respond to the need. Question. How is the DOD working with the VA to ensure the transition of servicemembers from DOD to VA is seamless and there is continuity of care? Answer. In order to ensure seamless transition of Service members from DOD to VA and continuity of care, DOD established the Department of Defense (DOD) Re- covery Care Coordinators (RCCs) and a Comprehensive Recovery Plan for each Wounded, Ill or Injured Recovering Service Member (RSM) who is unable to return to duty within a time specified by their Military Department and may be medically separated. RCCs provide non-medical support and services to RSMs and their families as they transition through recovery, rehabilitation, return to duty or reintegrate into the community. The RCCs, in collaboration with the medical and non-medical recovery teams, assess the needs of the RSM and create a Recovery Plan which guides the RSM through the phases of care and transition. Since the RSM owns his/ her Recovery Plan, it transfers with the Service member if he/she transitions out of the military. If the Service member separates from the military, the RCC coordinates with the VA OEF/OIF Liaisons, VA Transition Patient Advocates, and community programs to assist in establishing continuing non-medical support for the Service member and family as they reintegrate into the community. Additionally, Federal Recovery Coordinators (FRCs), established in 2007, provide service and support for the most severely injured Service members who are unlikely to return to duty. The FRCs, employed by the Department of Veterans Affairs (VA), reside in the Military Treatment Facilities and VA Medical Centers and provide non-medical care to severely wounded, ill and injured Service members and Vet- erans. The FRCs create a Recovery Plan that matches the DOD Recovery Plan. To further coordinate efforts, both the FRCs and the RCCs use the National Re- source Directory (NRD) as a source for resources and services. The NRD is an online partnership with Department of Labor, DOD, and VA to provide resources for wounded, ill and injured Service members, Veterans, their families and those who support them. Over 10,000 Federal, State and local resources are included in the NRD. Question. What is the status of the virtual medical records? Answer. The Virtual Lifetime Electronic Record (VLER) is in the pilot test phase. In January 2010, DOD’s Naval Medical Center San Diego and Veteran Affairs San Diego Medical Center conducted a VLER Phase 1a pilot and exchanged specific test patient data elements of a ‘‘Continuity of Care’’ document. This pilot demonstrated real time implementation of IT standards utilizing the Federal Health Architecture’s (FHA) Nationwide Health Information Network (NHIN). The project highlighted opportunities for improving those standards. The next phase, VLER Phase 1b, will build on the Phase 1a data set and expand it to additional military treatment facilities, VA Medical Centers, and health information exchanges in the Tidewater area in Virginia by the fourth quarter of fiscal year 2010 and the Spokane area of Wash- ington State by the second quarter of fiscal year 2011. The VLER will leverage investments made in the Departments’ existing electronic health record systems. VLER is a combined Department of Defense (DOD) and De- partment of Veterans Affairs (VA) initiative to integrate a portfolio of information sharing capabilities for the secure exchange of medical and benefits information among various departments of the Federal government and commercial sector healthcare providers. Question. I appreciate Secretary McHugh’s quick response and promise to resolve the issue at hand. Unfortunately, I see this as a broader problem between Active components and their Reserves counterparts. I understand the Reserve forces have different requirements because of their nature, but they still deserve the same respect, especially since they deploy and operate in the combat zones on a regular rotation like their Active counterparts. It appears that when both components are deployed, the Active/Reserve distinction falls away. However, this perception continues to remain at home. What efforts have been taken to address this perceived inadequate treatment? Answer. The DOD is aware of the perceived inequities among the Service components and, in the spirit of Total Force, working to reduce and eliminate them. Ex- amples are Post Deployment Initiatives, Equipping Units and Pre Deployment Training Certifications listed below. Post Deployment Initiatives.—Designed to inform Reserve Component (RC) members how to access resources in Finance and Budgeting, Healthcare, Mental Health, Reintegration, Stress Relief, Counseling. The Yellow Ribbon Program (YRP) is a De- fense-wide program which ensures Service members and their families are ready and resilient throughout the deployment cycle using information and access to local, 463

State, and Federal organizations. As of April 2010, more than 135,000 Service members (83,000 were National Guard members) attended YRP Events. Equipping Units.—It is DOD policy that the Guard and Reserve will be equipped to accomplish all assigned missions and will have an equipment procurement and distribution program that is balanced, sustainable and responsive to mission requirements. DOD has made it a priority to ensure that any unit, regardless of component, is properly equipped for in-theatre missions and for the National Guard domestic missions as well. Pre Deployment Training Certifications.—Previously, when RC units were called up, they had to complete training and be certified at the home station, by RC reviewers. Then, just prior to deployment, they were required to be certified again by the Active Component (AC) reviewers, even though it was for the same qualification. To resolve the inequality, AC now accepts the certification of Guard and Reserve commanders. Of the many initiatives undertaken, these are just a few examples that demonstrate the DODs commitment to create a Total Force which should ultimately eliminate all perceived inadequacies. Question. Proper equipping, regular military construction projects and demobilization health concerns seem to remain within the Reserve Component. How does the Department of Defense intend to address these concerns? Answer. The Department is addressing these concerns by ensuring that all units are properly equipped prior to going into deployed situations, and that each member is supported with comprehensive health programs throughout their life. The proper equipping, the effective training and the physical-mental well being of each and every Service member is a priority of the Department, throughout every stage of deployment. This priority is applied to create the Total Force, which includes the Re- serve Components. DOD will always make ensure that the men and women fighting or getting ready to fight in theater have the best equipment available, regardless of component. The Department has a thorough requirements process that balances current operations with future plans. While the Reserve Components do not have their own procurement appropriation, we have implemented and continue to improve upon the recommendations in this area from the Commission on the National Guard and Re- serves and other stakeholders. This will give DOD and Congressional leaders greater visibility and an improved ability to track delivery of equipment through the system to the Guard and Reserve. There is a direct correlation between readiness and facilities, particularly in the Reserve Component (RC). Because the mission of the RC is to equip, train, and prepare for war, it is imperative that the RC have and maintain quality facilities to meet their operational, maintenance, training, and mobilization requirements. Post-Deployment Health Assessments are given to each Service member prior to redeployment or release from active duty. The assessment gathers information on the health concerns or problems that the Service member feels are related to deployment. Face-to-face health assessments with healthcare providers are provided to determine the need for referral for appropriate medical follow-up. Military and Vet- eran’s Affairs (VA) providers use the jointly developed Post-Deployment Health Clin- ical Practice Guideline to focus healthcare on post deployment problems and concerns of the Service members returning from deployments. Initiatives such as Yel- low Ribbon events are vital for post mobilization healthcare. These events are conducted during pre, mid and post deployment phases and are designed to inform RC members how to access resources in healthcare, mental health, reintegration, stress relief, counseling and suicide prevention.

QUESTIONS SUBMITTED BY SENATOR THAD COCHRAN Question. Secretary Gates, last month the Administration sent over a late legislative proposal that would provide up to $205 million to the Israeli government for accelerated development and fielding of the Iron Dome defense system which is designed to counter short range rockets and large caliber artillery shells. The requested authorization stated that funding would be provided from offsets as approved by you, the Secretary of Defense. Can you share with the committee what programs you would consider cutting in fiscal year 2011 to fund this new initiative? Answer. At this time, no decision has been made as to what programs would be reduced to finance the Iron Dome transfer. Assuming the Congress provides the requested authority, we will make the specific program reductions during the execution of the enacted fiscal year 2011 budget. 464

Question. Secretary Gates, last spring you announced an initiative to replace contractors and hire more than 13,000 government civilians in fiscal year 2010. This initiative was expected to achieve $900 million of savings in 2010 alone. Can you update the Committee on the number of positions that have been in-sourced and what savings have being realized? Answer. As of March 31, 2010 (end of the 2nd quarter), the Department has established approximately 15,270 new civilian authorizations as a result of in-sourcing contracted services. The Department’s in-sourcing efforts to rebalance the workforce, rebuild critical capabilities internally, and reduce operational risk are focused on services being performed by the private sector that are more appropriately performed by DOD personnel. In-sourcing is a component of the Department’s broader Total Force management policies, focused on ensuring we have the capacity, skills, and resources to carry out our missions and operations. While the fiscal year 2010 budget reflected reductions of approximately $900 million as a result of in-sourcing, our efforts are not focused on, or driven solely by, cost. More than 50 percent of the in-sourcing actions executed to date in fiscal year 2010 did not consider cost as a deciding factor but were required to return inherently governmental or exempt (job functions closely associated with inherently governmental or needed to support readiness/management needs) services to government performance. Due to our focus on other factors such as job function rather than cost alone the Department is not centrally tracking savings realized from individual in-sourcing decisions.

QUESTIONS SUBMITTED BY SENATOR CHRISTOPHER S. BOND Question. In order to keep America on the cutting edge of new weapons and defense systems, I fail to recognize the strategic value in closing the only active production line for long-range strategic airlifters when there is no replacement being developed and as the operational fleet is being used up faster than expected. You may recall that I vocalized the point during the Defense Subcommittee on Appropriations hearing on the DOD budget. You responded by explaining that America’s wide-body civilian aircraft manufacturing base would more than adequately supplant military aircraft manufacturers in the event that the nation may need to surge its production of military airlifters in response to a national emergency or even another humanitarian crisis somewhere around the world. Is this an accurate interpretation of your response? Answer. Yes. Requirements for commercial cargo aircraft continue to rise for outsize and heavy lift capability, including planes that can operate in remote and austere environments. Numerous industries—including construction, mining, oil and gas equipment, power generation, railroad, and satellite companies—have requirements to quickly transport heavy, oversize equipment. The technology and processes used by the wide-body civilian aircraft manufacturing base are readily available, mature, and directly applicable to those used by military airlift manufacturers. I am confident that when the time comes in the future to produce additional military airlift, America’s aerospace industry will be able to respond to the need. Question. If not, will you please clarify your answer that: ‘‘There is significant wide-body aircraft production capability in the United States. And we have more than enough time to adjust it to a military production line if we need to.’’ Answer. The development and manufacturing know-how resident in the commercial aviation sector—particularly in the field of wide-body aircraft—can be easily adjusted to support future military airlift requirements that may arise. Moreover, the C–17s set to roll off the production line, coupled with those already in the field, will have a very long lifespan and provide a substantial capability to support strategic airlift requirements over the next 30 years. Question. In particular, please provide me with a better understanding of your basis of evidence for concluding that our civilian airplane manufacturers can adequately replace the expertise and engineering know-how of the manufacturers of military strategic airlifters, which require specifications not common to civilian aircraft. Answer. The Department’s industrial capabilities assessments include, among other things, a determination of the viability of any essential industrial/technological capabilities. Transport airframes, as well as many of their high-value subsystems, are commercial, off-the-shelf (COTS) or COTS derivative items. These high- value subsystems include engines, avionics, auxiliary power units, environmental control systems, and ground proximity warning systems. Transport airframes and subsystems rely heavily on commercial technologies, processes, and products and will be sustained by other ongoing and planned military and commercial aerospace 465 programs. The non-COTS items in a military transport such as cargo floor reinforcement and loading systems are not considered essential military capabilities. Question. Global lift distinguishes America above all other militaries. How can we preserve that capability if we allow all the engineers’ and designers’ specialized skills to atrophy and then never recover them? Answer. Continued production of global lift aircraft would do little to stem the loss of military-unique skills, processes, facilities and technologies due to the high commercial off-the-shelf content. Military-unique aerospace design skills at risk include hypersonics, canopy and cockpit design and integration, stores management and weapons separation, aerodynamics, etc.—none of which would be maintained by continued production of global lift aircraft. From a design and development standpoint, global lift aircraft are based on commercial products or derivatives of commercial products and, therefore, should not cause any reduction in any inherent design capabilities. There is very little military-unique technology involved in developing or manufacturing airlift aircraft.

QUESTION SUBMITTED BY SENATOR MITCH MCCONNELL Question. Last year, Fort Campbell suffered 11 soldier suicides, apparently one of the highest figures of any military post. Have other military installations, with units facing similar operational tempo as those housed at Fort Campbell, experienced comparable absolute numbers of suicides and similar rates of suicide? If not, and if the suicide rate at Fort Campbell is uniquely high, has the Army conducted a formal inquiry into the suicide rates to determine what accounts for the high number? Answer. Yes, while Fort Campbell had the highest number of suicides in 2009, other bases with similar populations and unit deployment profiles had high suicide rates as well. For all of 2009, Fort Campbell (21), Fort Hood (11), Fort Stewart (10), Fort Carson (9), and Schofield Barracks (7) accounted for 39 percent of Active Duty deaths (162). As of June 25, 2010, Fort Hood (11), Joint Base Lewis McChord (8), Fort Bragg (6), and Fort Carson (5), in the top of the list, account for 51 percent of the 74 Active Duty suicide deaths this year. When compared to the same point last year (June 25), the Army had 87 suicide deaths. The Army’s senior leadership is committed to sustaining our current emphasis on this problem. The Army sent a team from the Public Health Command to Fort Campbell in June 2009 to examine issues related to their suicide trend. This team scrutinized organizational factors such as the length of time small unit leaders were in their leadership position, total time each unit leader had in their Army career, and specific types of formal or informal people skills and leadership training leaders received to determine if any of these factors played a role. This team did not find any significant patterns or trends that accounted for Fort Campbell’s rate.

QUESTIONS SUBMITTED BY SENATOR KAY BAILEY HUTCHISON

GLOBAL DEFENSE POSTURE Question. I believe the GAO review of our European force structure plans will show the anticipated savings moving the Army from Heidelberg to Wiesbaden will not materialize, so I am at a loss as to why a component of EUCOM needs its own headquarters of the proposed magnitude. I hope as part of your review of reducing overhead cost and redundant capabilities you relook at that decision and evaluate Stuttgart at a consolidation location, where EUCOM, Army Europe and even AFRICOM can share the most technical and expensive resources. The Army request for a $91 million SCIF and a $120 million Command and Battle Center at Wies- baden are prime examples. Mr. Secretary, in light of your comments on needing to reduce redundant capabilities and overhead cost I am interested in why you believe, in our current fiscal situation, we need to expend our limited taxpayer dollars in Europe when we can achieve the same readiness capabilities by stationing more of our forces in America, where we can provide jobs for local communities and stability and support for our soldiers and their families. Will you reconsider the Army’s planned move to Wies- baden or review the Milcon requirements at that location that could be shared with the facilities at Stuttgart? Answer. The consolidation of 7th Army Headquarters/U.S. Army Europe (HQ/ USAREUR), along with its signal and intelligence elements, at Wiesbaden, Ger- many will allow the closure of three bases in Europe, resulting in a reduced footprint, while providing the facilities necessary to support current and future oper- 466 ations in the U.S. European Command (USEUCOM) area of responsibility (AOR). The Department is currently executing fiscal year 2009 funding associated with the Wiesbaden consolidation. Military Construction funding included in the fiscal year 2011 President’s budget request would fund construction of the second increment of the Command and Battle Center, an Information Processing Center, and a Sensitive Compartmented Information Facility. The Department determined that it continues to make operational sense to move forward with this initiative, and that savings realized should equal implementation costs by fiscal year 2016. The Department re-examined the consolidation of 7th Army HQ/USAREUR at Wiesbaden in the 2010 Quadrennial Defense Review and validated the original decision. Consolidation at Stuttgart was not considered as USEUCOM, U.S. Africa Com- mand (USAFRICOM), and other supporting elements are located there; we are concerned about additional stress on these facilities, which could overwhelm capacity. We will continue to examine opportunities for military construction efficiencies and shared facilities.

SOUTH KOREA Question. I am concerned about our future commitments in 2012 and beyond. The cost of housing, schools, hospitals, clinics, fitness centers, recreation facilities, child care centers, youth centers, and other support facilities such as commissaries and PX exchange services will be staggering. We have not been given any cost estimates on these facilities so we have no way to evaluate the total cost of a decision of this magnitude. Mr. Secretary, have you approved this new plan and can you give us an out-year cost we will be asked to commit the U.S. taxpayer to for a major shift in strategy such as this? Answer. I am also concerned about costs, but my true motivation is to support the deployed troops and their family members in a time of shrinking budgets and fiscal constraints. Yes, I approved a Tour Normalization effort that allows for command-sponsorship of approximately 4,900 families in South Korea by 2012. The funding for this requirement is contained in the President’s fiscal year 2011 budget request, which includes $536 million across fiscal year 2011–2015 for Tour Normal- ization primarily to provide housing in the form of the Overseas Housing Allowance. As you note, these families require supporting infrastructure, and the intent of the Yongsan Relocation Plan and the Land Partnership Plan is to cover these requirements (both of which include cost sharing from the Republic of Korea). This covers the infrastructure costs for schools, hospitals, clinics, fitness centers, recreation facilities, child care centers, youth centers, and other support facilities. I will continue to closely monitor changes in timelines and requirements as I consider how to most cost effectively implement this plan. If there are additional costs, then they will be included in the President’s fiscal year 2012 budget request after the Department considers all issues for the next budget submission.

QUESTIONS SUBMITTED BY SENATOR ROBERT F. BENNETT Question. For the record, Secretary Gates, was anyone at the Pentagon consulted about the national security implications prior to NASA making a decision to cancel the Constellation program? Could you state, for the record, what are those national security implications? Answer. During the Augustine Committee data collection efforts, research analysts working on behalf of the OSTP asked staff from the Office of the Under Sec- retary of Defense for Acquisition, Technology, and Logistics/Industrial Policy for a copy of the Department’s most recent Solid Rocket Motor Industrial Capabilities As- sessment report to Congress, which is dated April 2, 2009. Additionally, the committee analysts discussed the findings and results of the report with the Industrial Policy staff. No official interaction took place on the matter above the analyst and staff levels of our respective organizations. To the best of our knowledge, there was no other interaction. Our most complete assessment of the evident national security implications is captured in our June 2010 report titled, Solid Rocket Motor Industrial Base Interim Sustainment Plan To Congress. Question. Just last week, Administrator Bolden sent a letter notifying the Con- gress of the agency’s intention to ‘‘pace’’ Constellation efforts for the remainder of this fiscal year. This latest action will have an immediate and devastating impact on the aerospace workforce, including the likely layoff of as many as 2,500 workers from within the solid rocket motor industry alone. 467

Secretary Gates, was anyone at the Pentagon consulted prior to this most recent decision by NASA to ‘‘pace’’ the remainder of the fiscal year 2010 Constellation effort? Answer. To the best of our knowledge, no official interaction took place between NASA and the DOD relative to NASA’s intention to ‘‘pace’’ the Constellation effort. Question. Secretary Gates, it is extremely likely that this panel will have acted on the Administration’s fiscal year 2011 budget submit long before the Department delivers its plan to sustain the solid rocket motor industrial base. Even in the absence of the Department’s recommendations, this panel is being asked to make significant budgetary decisions that affect the future viability of this industry. Specifi- cally, not yet clear is the Department’s commitment to sustaining the Minuteman propulsion system. Also not yet clear is whether the Missile Defense Agency will respond to congressional concerns, and sustain production of the Ground-based Mid- course Defense missile supplier base, or sustain the SM–3 Block IA until Block IB is proven. In the absence of your Department’s official recommendations via delivery of the solid rocket motor industrial base sustainment plan, what path would you suggest for this committee? What can you share with this panel now about the pending plan’s recommendations? For example, will the implementation plan emphasize investment in research and development, continued production via essential warm line programs, or both? It seems only prudent that this committee recommend sustained low rate production for all our large solid rocket motor systems—including both the land-based and submarine-launched strategic deterrent missiles, and all our deployed missile defense boosters. These low rate production programs ensure that the industrial base is able to meet the aging and obsolescence-related needs of current deployed systems, and prepared to develop our next generation systems. Answer. The Department submitted an interim SRM Sustainment Plan in June 2010 that laid out the options DOD is considering as it develops its final sustainment plan. The Department is working aggressively to complete a full sustainment plan in keeping with the end of September deadline discussed in the preliminary plan. It is premature to provide the specific approach the Department will pursue as the plan will include resource commitments and potential policy considerations. As indicated in the interim plan, the Department needs to continue its efforts to develop an investment strategy that supports our strategic requirements now and well into the future, while at the same time motivating the suppliers to ‘‘right-size’’ the industrial capacity to better reflect the reality of the future needs. This investment strategy must include adequate basic science and technology, demonstration and validation programs, and production programs to sustain a viable, innovative, and competitive industry. The Department believes that the appropriate investment strategy will include elements of the following: —Funds sufficient to maintain properly qualified production processes. —Funds sufficient to exercise production skills. —Funds sufficient to support aging studies, to maintain safety and reliability at appropriate levels. —Funds sufficient to support design and development efforts directed at improving and sustaining current designs. —Funds sufficient to support design and development efforts for a successor class missile, the SRM concepts from which could be employed for both Navy and Air Force needs, as well as other DOD programs. The DOD strongly supports both investments in research and development and in production. The DOD is committed to supporting our ongoing force structure and ensuring we have a robust base in support of that effort. However, this does not necessarily mean we support continued warm-line programs on all our large SRM programs. The Department believes that production continuance alone, no matter where directed, will be insufficient to protect and/or restore critical technical and creative skills necessary for future missile production and current missile sustainment. The Department also believes the ‘‘right-sizing’’ process will likely come with a cost that will be seen both as a unit cost increase for DOD systems and potentially, near-term increases in facility costs. 468

QUESTIONS SUBMITTED TO ADMIRAL MICHAEL G. MULLEN

QUESTIONS SUBMITTED BY CHAIRMAN DANIEL K. INOUYE

SOMALIA Question. Admiral Mullen, recent press reports have highlighted the growing presence and influence of foreign fighters and al-Qaeda in Somalia’s Islamist al-Shabab group. How would you assess the threat posed by these groups to western interests in East Africa? Is Somalia becoming the ultimate safe haven for al-Qaeda and foreign fighters? Answer. [Deleted]. Question. Admiral Mullen, do you have sufficient resources to adequately focus on the situation in Somalia? Answer. I appreciate your support for the resources requested in the President’s budget to support Somalia, including those for enabling activities, such as ISR. We are comfortable that our request will provide the appropriate level of resources to address challenges in Somalia, a complex nation that includes a transitional government struggling to establish itself with the support of the African Union. Question. Admiral Mullen, do you consider the Somali al-Shabab group a regionally focused threat or a direct threat to the U.S. homeland? Answer. [Deleted].

IMPACT OF CHANGING HEALTH BENEFITS ON SERVICE MEMBERS Question. Admiral Mullen, this is a very different military from the one I joined many years ago. Today, most service members are married and have children. The cost of maintaining this all-volunteer force is much higher than in my day. As such, there is a lot of discussion about the rising personnel costs and finding ways to curtail the growth. What would the impact of reducing benefits be on the individual soldier? We’re currently providing terrific healthcare coverage, so would a change to that break the faith with the soldier and negatively impact his or her willingness to serve? Answer. Yes, a reduction in medical benefits could break the faith with the soldier and negatively impact his or her willingness to serve. In my CJCS 2009–2010 Guidance, I reemphasized that it is our core responsibility to win wars while caring for our people and their families. I believe that as a Na- tion, we have the solemn obligation to fully support our service members and their families. I also believe that our culture must value and support a continuum of care that lasts a lifetime and encompasses military members, retirees and their families. In order to make this cultural shift, there must be constant attention and cooperation between the Joint Staff and the Chiefs, and close work with the Office of the Secretary of Defense and the Department of Veteran Affairs. The country faces mounting deficits and growing debt. This is going to require difficult budget decisions for our government. As we carry out our assigned missions and reset a tired force, we must guard against growing hollow. The quality of the force remains paramount. The Military Health System (MHS) portion of the Defense budget is steadily increasing. Currently, private sector healthcare costs are increasing at a rate of about 10 percent per year. In order to engage this issue, we have looked at implementing several healthcare initiatives that could generate future savings for the department. These initiatives include: Administrative.—Medicare Payment Matching Initiative/Sole Community Hos- pital; Fraud Waste and Abuse investigation and reduction; and Medical Supply Chain Standardization. Benefit.—Uniformed Services Family Health Plan (USFHP) Medical-Eligible Ini- tiative; TRICARE Beneficiary Fee Increase; and TRICARE Survey/Demonstration for Opt-Out Initiative. There has been no discussion of reducing the benefit to the AC and RC, rather we are increasing benefits in the areas of mental health and traumatic brain injury, and rehabilitative care while adding innovative programs such as medical centered home to improve continuity and quality while potentially decreasing long term costs. Likewise, there is no indication from DOD leadership that they intend to reduce the medical benefits to the AC and RC and their families. The wars in Afghanistan and Iraq will end and we must think today about how the U.S. military will need to adapt to future threats. The health-of-the-force investments that we make today will pay dividends in the national security tomorrow and well into the next generation. 469

CHINA Question. Admiral Mullen, recent press reports have highlighted growing Chinese investments in their military capabilities. As we continue to focus our efforts on Iraq, Afghanistan, Yemen and now Somalia, do we have sufficient resources focused on the challenges posed by an increasingly capable Chinese military? Answer. Secretary Gates and I have placed a priority on ensuring that our service members have the tools they need to do their job, while continuing to prepare for potential contingencies across the spectrum of conflict. China has made significant investments in modern warfighting capabilities, particularly over the past two decades. While not directed at China specifically, it is of vital importance that the United States is positioned to prevail against any potential adversary, including those with advanced conventional and/or Anti-Access/Area Denial (A2/AD) capabilities. Some examples of programs in the fiscal year 2011 budget that sustain the United States’ long-standing edge in conventional warfighting include: —Electronic Warfare.—Procurement of 12 EA–18G ‘‘Growler’’ aircraft to recapitalize four expeditionary electronic attack squadrons. —Cyber Command.—Establishment of U.S. Cyber Command to organize and standardize DOD cyber practices and operations in defense of the Global Infor- mation Grid (GIG). —Joint Strike Fighter.—Procurement of 42 aircraft in fiscal year 2011. JSF will ensure continued air dominance over current—and future—battlefields. —Shipbuilding.—Procurement of 10 ships, all of which would be extremely relevant in a conventional campaign—2 Virginia-class SSNs, 2 Arleigh Burke class destroyers, 2 Littoral Combat Ships, 1 Landing Helicopter Assault-Replacement (LHA–R), 1 Mobile Landing Platform (MLP), and 2 Joint High Speed Vessels (JHSVs). Question. Admiral Mullen, do you see a time in the near future where we will be able to improve our military to military ties with China? Answer. I believe there is potential for an improved military-to-military relationship with China in the near future; however, China has recently been unwilling to engage with the U.S. military. While disagreements will exist, these must not prevent cooperation in support of our mutual interests and our international responsibilities. I believe that China’s military leadership will recognize the importance of continuing to work together with the United States to promote regional stability, in spite of our differences. Therefore, my invitation to my counterpart, PLA Chief of General Staff, General Chen Bingde, remains open and I look forward to meeting him here in Washington, and reciprocating the visit in Beijing to discuss how we can better define our military-to-military relationship.

QUESTIONS SUBMITTED BY SENATOR PATRICK J. LEAHY Question. Admiral Mullen, there is a so-called ‘‘fighter bathtub’’ issue looming over the future of the Air National Guard. In my role as the Co-Chair of the Senate Na- tional Guard Caucus, I am very concerned that our plan for the Air Force does not fully leverage the benefit of the Air National Guard’s greater cost-effectiveness or the greater experience of its pilots and maintenance crews compared to the Active Component. Can you explain your vision for the role of the Air National Guard in the future Air Force mission? Do you believe that the current Air National Guard legacy fighter fleet should be re-capitalized, or do you believe that as fighter wings are retired, those states’ Air Guard units should assume new missions with smaller counter-nar- cotic aircraft or even unmanned airframes? Answer. The Air National Guard (ANG) and Air Force Reserve Component (AFRC) are full partners in the Air Force’s Total Force Integration (TFI), providing critical capabilities for the Joint Warfighter across the full spectrum of conflict. The fiscal year 2011 President’s budget reflects a complete review of the Air Force fighter requirement which was developed based on the Secretary of Defense’s guidance for Development of Forces, through examination of the current and future strategic environment, and using high fidelity campaign modeling. Today the ANG flies both the newest and some of the oldest fighter aircraft in the Air Force inventory. The fiscal year 2010 budget retired 257 of the Air Force’s oldest fighter aircraft and recapitalized a number of ANG units with newer and more capable 4th generation fighters from the active inventory. In fiscal year 2011 F–22s are being delivered to the 154th Wing in Honolulu, Hawaii, and F–22 ANG and AFRC TFI programs presently exist at Langley, Holloman, and Elmendorf AFBs. As the F–35 is delivered to both the Active and Reserve Component, addi- 470 tional 4th generation aircraft will become available to recapitalize older ANG and AFRC fighters. The Air Force is refining the current TFI approach to develop a future TFI game plan based on strategic and operational use of the Active and Reserve Components. The Air Reserve Component will provide critical capabilities for the Joint Warfighter in fighters as well as new and emerging missions that capitalize on the ARC’s experience, expertise, and expeditionary capacity. Question. Admiral Mullen, Senator Bond and I recently sent a letter to Chairman Inouye and Vice Chairman Cochran on behalf of the Senate National Guard Caucus requesting $870 million for the National Guard and Reserve Equipment Account. Even though the National Guard and Reserves have shouldered more than their share of the operational responsibilities at home and abroad, they still lag behind the Active Component in terms of getting the equipment they need. Why do they still face this shortfall, and what is the Department’s long-term plan for fixing it? Answer. Over the past decade the Department of Defense has made tremendous strides in providing the best available equipment across all components. There was a time when the Reserve Components lagged significantly behind the Active force in both the quantity and quality of their equipment requirements, but in my assessment, this gap has closed significantly. Since 9/11/2001, our priority of effort has been to equip deploying units first. The Department has steadily improved the readiness posture of the Reserve Compo- nents, clearly transforming them from a Strategic Reserves to an Operational Force. Given the exigencies of fighting two simultaneous wars with all components participating, Department leaders realize that all of our forces need to be equipped appropriately. In 2007, the Department issued directives to better manage the Reserve Components as an Operational Force. One key aspect of this shift has been to properly equip the Reserve Components with modern, interoperable equipment which has contributed to both the transformation and success of our national security strategy. The Department has also been focused on critical equipment requirements that sustain efforts which protect the home front. We have improved the percentage of National Guard Critical Dual-Use equipment available to the Governors by 22 percent over the last 5 years. This has occurred through an increase of overall Reserve Component equipment funding from approximately $3.3 billion in 2005 to just over $9.9 billion in 2009, as well as additional funding from the Congress. The Army Equipping Strategy published in 2009 specifically acknowledged the need for Critical Dual-Use equipment to be filled at 80 percent or better. While the overall on-hand rate stands at 83 percent, due to the quantity of equipment deployed to support contingency requirements, only 65 percent of Critical Dual-Use equipment is currently available for use here at home. However, the Army projects being able to reach a fill rate of 87 percent by March 2011. No unit has failed to complete any assigned homeland mission in the past due to equipment shortages because the risk has been mitigated through the use of the Emergency Management Assistance Compact between States. The Deputy Secretary of Defense, in an effort to lessen equipment shortages, directed implementation of a plan that has been executed since August 2009 that properly equips deployed units, while sustaining a trained and ready force. In doing so, the Department is striving to ensure the Reserve Components have the right equipment, available in the right quantities, at the right time, and at the right place to support the Total Force mission. As an example, the Army committed to resolve truck shortages—Family of Medium Tactical Vehicles (FMTVs)—that support our ground forces. The Army’s FMTV modernization plan projects that both the Army National Guard and Army Reserve will be equipped at 100 percent fill by fiscal year 2015. In the interim, the Army National Guard is modernizing its 900 Series trucks in order to maintain operational fleets. The Air Force has strived to place emphasis on modernizing legacy aircraft and associated equipment across the Total Force. As an example, modernization efforts of the C–5A, flown by 3 National Guard units, are underway with modifications to its aircraft defensive systems which permit operations in hostile environments. Without these modifications, C–5As are not permitted to enter certain airfields in key areas of operation. An upgrade to this system is estimated at $34 million. The Department’s next step is to maximize efforts to implement recommendations articulated in the Quadrennial Defense Review and other strategic planning efforts that support the nation’s use of the Reserve Component. This is especially important as the Services address the long-term funding needed to reduce equipment de- terioration created by multiple or sustained deployments. We will continue to replace aging and maintenance-intensive equipment across the Services and modernize capabilities to ensure effective inter-operability. 471

Additionally, we are pressing to implement the recommendations outlined within the Commission on the National Guard and Reserve Report, many of which target the improvement of equipment readiness and transparency of the Reserve Compo- nents. This includes meeting funding requirements for Reserve Component equipment procurement as well as ensuring the visibility, transparency, and accountability of National Guard and Reserve equipment from planning, programming, and budgeting, through acquisition and fielding. We will continue to work to close the remaining equipment gaps between the Ac- tive and Reserve Components. Your continued support and programmed funding in this endeavor has been essential and greatly appreciated.

QUESTION SUBMITTED BY SENATOR PATTY MURRAY Question. Still, I am still very concerned about the health and welfare of our service members with visible and invisible wounds. Recent events with the Army War- rior Transition Units have demonstrated that we still have a lot of work to do to ensure the health and welfare of the servicemembers remaining on active duty or transitioning into the VA system. Admiral Mullen, I know combat related stress is a great concern for you and each of the service chiefs, how is the DOD improving upon the existing mental health programs? Are you implementing new programs? Answer. A broad range of programs have been designed and implemented to sustain the health and well being of active and reserve Service members and their families before, during, and after deployment. There has been a series of both operational and in garrison programs implemented to include bolstering our Combat stress teams in theater; developing stress control programs to prepare Service members to better cope with combat and deployment stress; programs that target medical providers who may be experiencing provider fatigue; implementation of a DOD- wide Total Force Fitness program as an approach to strengthen resilience and enhance endurance to maintain optimal military force readiness; Wounded, Ill and In- jured Program addressing reintegration needs of the wounded, ill, and injured striving to be responsive to the needs of our wounded warriors and their families; reintegration assistance programs across the DOD to assist with reintegration of the family. The Defense Centers of Excellence (DCoE) for Psychological Health and Traumatic Brain Injury (TBI) provides a number of education and outreach programs to include a 24/7 help-line; real warriors campaign multimedia public education effort which combats stigma associated with seeking psychological healthcare and encourages utilization of available psychological health resources. In addition, the Joint DOD and VA Health Executive Council’s (HEC) Mental Health Working Group is an expert panel who plan and implement procedures to create a seamless transition of care aimed at improving the access, quality, effectiveness, and efficiency of mental health services for all Active Duty, National Guard, Reserve, Vet- erans, and their families. Although we have embarked on many programs to provide the best possible psychological healthcare for our warriors and family members, I still have concerns with the invisible wounds and we still have work ahead of us. The OASD–HA Office of Strategy Management recently conducted a Psychological Health/TBI Program Review which detected gaps in existing programs. Additionally, the DOD has been slow to engage in opportunities for collaboration with the civilian sector academia and pure scientific research in the area of brain mapping and psychological health research; the lack of comprehensive entry psychological evaluations is evident and we lack the resources (professional staff, funding and time) to conduct more detailed and comprehensive psychological health assessment of Service recruits and candidate prior to and during initial induction into the military. We as a Department need to stratify our outlook beyond the current issues and align our psychological health goals and objectives in the manner of a preemptive strike and not in the manner as a reaction to a strike. As I have stated before, how we take care of those who are wounded and their families, and the families of the fallen, is right at the center of my life. They’ve done exactly what we’ve asked them to do. They’ve put themselves in harm’s way, and many of them have not come back. There is, in my view, no higher duty for this nation, or for those of us in leadership positions, than to care for those who sacrifice so much and who must now face lives forever changed by wounds both seen and unseen. I think leaders throughout the land and throughout communities in our country need to reach out and make sure that we are meeting the needs of these great, young Americans who sacrificed so much. And not just the military members, but their families. And while we’ve made a lot of progress in the last several years, we still have an awful long way to go. 472

SUBCOMMITTEE RECESS Chairman INOUYE. The Defense Subcommittee will reconvene on Wednesday, June 23, at 10:30 a.m., to hear testimony from public witnesses. Until then, we will stand in recess. Thank you. [Whereupon, at 12:10 p.m., the subcommittee was recessed, to reconvene at 10:30 a.m., Wednesday, June 23.] DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2011

WEDNESDAY, JUNE 23, 2010

U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10:30 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) presiding. Present: Senators Inouye and Cochran. NONDEPARTMENTAL WITNESSES OPENING STATEMENT OF CHAIRMAN DANIEL K. INOUYE Chairman INOUYE. I would like to welcome everyone to this hearing where we receive public testimony pertaining to various issues related to the fiscal year 2011 Defense appropriations request. Because we have so many witnesses today, I would like to remind each witness that they will be limited to no more than 4 minutes apiece. But I can assure you that your full statements will be made part of the record. And at this point, I would like to recognize the vice chairman of this subcommittee, Senator Cochran of Mississippi. STATEMENT OF SENATOR THAD COCHRAN Senator COCHRAN. Mr. Chairman, thank you very much. I am very pleased to join you and welcome our witnesses who are here today to talk about their views in connection with the Defense Department’s fiscal year 2011 budget. We appreciate your assistance and the time you have taken to prepare your remarks and to present them to us today. Thank you very much. Chairman INOUYE. The subcommittee has divided the witnesses into four panels. And the first panel consists of Mr. H. James Gooden; Rear Admiral Casey Coane of the Navy, retired; Ms. Janet Hieshetter; and Mr. John R. Davis. Mr. Gooden, are you prepared? STATEMENT OF H. JAMES GOODEN, CHAIRMAN, BOARD OF DIREC- TORS, AMERICAN LUNG ASSOCIATION Mr. GOODEN. Yes, I am. Chairman INOUYE. Please proceed. Mr. GOODEN. Mr. Chairman, Mr. Vice Chairman, and members of the subcommittee, my name is Jim Gooden, and I am the chair- (473) 474 man of the board of directors of the American Lung Association. I am honored to testify today. The American Lung Association was founded in 1904 to fight tuberculosis, and today, our mission is to save lives by improving lung health and preventing lung disease. We accomplish this through research, advocacy, and education. The American Lung Association wishes to call your attention to three issues for the Department of Defense’s fiscal year 2011 budget. Number one, the terrible burden on the military caused by tobacco use and the need for the Department to aggressively combat it by implementing recommendations from the Institute of Medi- cine. Two, the importance of restoring the original intent and full funding for the Peer-Reviewed Lung Cancer Research Program. And number three, addressing the health threat posed by burn pits in Iraq and Afghanistan. First, I would like to speak to the need for the Department of De- fense to better combat tobacco use. Tobacco use remains a significant problem for the military. The Department of Defense has started moving in the right direction with making submarines smoke free, as well as other positive actions. But much more is needed to curb tobacco use in the military. Here are a few statistics to point out to what the Department of Defense is up against. While smoking rates among Active Duty personnel have essentially remained steady since 2002, rates among deployed personnel are significantly higher, and alarmingly, more than 1 in 7, or 15 percent, of Active Duty personnel began smoking after joining the service. This alarming use of tobacco in the military has severe consequences and impacts troop readiness. It impairs physical capacity, vision, and hearing, and increases the chance of physical injury and hospitalization. Furthermore, the healthcare expenses associated with these behaviors have cost the Department of Defense billions of dollars. The Pentagon spends over $1.6 billion on tobacco-related medical care, increased hospitalization, and lost days of work. Lost productivity costs are primarily caused by smoking breaks and greater absenteeism. Last summer, the prestigious Institute of Medicine, or IOM, issued a report entitled ‘‘Combating Tobacco Use in Military and Veteran Populations.’’ The IOM recommendations include commonsense approaches to eliminating the use of tobacco in the U.S. military. Some of the IOM’s recommendations include tobacco-free policies should be phased in, starting with military academies and officer candidate training programs, followed by new enlisted accessions and then all Active Duty personnel. Also, end the sale of tobacco products on all military installations. Ensure that all DOD personnel have barrier-free access to tobacco cessation services and that healthcare and health promotion staff are trained to help tobacco users quit. The American Lung Association recommends that the Depart- ment of Defense implement all recommendations called for in the 2009 IOM report, and we ask for this subcommittee’s leadership in ensuring that that happens. Second, the American Lung Associa- tion strongly supports the Lung Cancer Research Program (LCRP) 475 in the Congressionally Directed Medical Research Program and its original intent to research the scope of lung cancer in our military. We urge this subcommittee to restore the funding level to the fiscal year 2009 level of $20 million, and we request that the 2011 governing language for the LCRP be returned to its original intent as directed by the 2009 program, which directed the funds to be awarded competitively and to identify, treat, and manage early curable lung cancer. We urge that the national registry be established to track all personnel who were exposed to burn pits while in Iraq. The American Lung Association also recommends that the DOD begin immediately to find alternatives to this method of waste disposal. Mr. Chairman, in summary, our Nation’s military is the best in the world, and we should do whatever necessary to ensure that the lung health needs of our armed services are fully met. Thank you for this opportunity. Thank you very much, Mr. Chairman. Chairman INOUYE. Just a matter of curiosity, when I was a young soldier, we were given K-rations for lunches, and in each pack, there was a little pack of cigarettes. And then you were able to buy cigarettes, if you wished to, for 5 cents a pack. When were these practices ceased? Mr. GOODEN. To that, I will have to defer to my other specialists that are here with me from the American Lung Association, and if they cannot answer at this time, we will gladly be able to put that on the record. Chairman INOUYE. Thank you very much. Mr. GOODEN. Thank you, sir. [The statement follows:]

PREPARED STATEMENT OF JAMES GOODEN Mr. Chairman and members of the Committee, my name is James Gooden and I am the Chairman of the Board of Directors of the American Lung Association. I am honored to testify today. The American Lung Association was founded in 1904 to fight tuberculosis and today, our mission is to save lives by improving lung health and preventing lung disease. We accomplish this through research, advocacy and education. The American Lung Association wishes to call your attention to three issues for the Department of Defense’s (DOD) fiscal year 2011 budget: the terrible burden on the military caused by tobacco use and the need for the Department to aggressively combat it; the importance of restoring funding for the Peer-Review Lung Cancer Re- search Program to $20 million; and the health threat posed by burn pits in Iraq and Afghanistan. First, the American Lung Association is concerned about the use of tobacco products by troops within the military. The effects of both the health and performance of our troops are significantly hindered by the prevalence of smoking and smokeless tobacco products. As a result, we urge the Department of Defense to immediately implement the recommendations in the Institute of Medicine’s 2009 Report, Com- bating Tobacco Use in Military and Veteran Populations. Next, the American Lung Association recommends and supports restoring funding to $20 million for the Peer-Reviewed Lung Cancer Research Program (LCRP) within the Department of Defense Congressionally Directed Medical Research Program (CDMRP). We were disappointed that this critical public health research program was cut in fiscal year 2010 by $5 million and ask that the funding return to $20 million. Finally, the American Lung Association is deeply troubled by reports of the use of burn pits and the negative effects on lung health on soldiers in both Iraq and Afghanistan. Thus, we urge the DOD to immediately find alternatives to this method of waste disposal. 476

Combating Tobacco Use Tobacco use remains the leading cause of preventable death in the United States and not surprisingly, is a significant problem within the military as well. The DOD has started moving in the right direction with its recent smoking ban on submarines and other positive actions, but much more is needed to curb tobacco use in the military. The 2008 Department of Defense Survey of Health Behaviors among Active Duty Personnel found that smoking rates among active duty personnel have essentially remained steady since 2002. However, smoking rates among deployed personnel are significantly higher and, alarmingly, more than one in seven (15 percent) of active duty personnel begin smoking after joining the service. Currently, the smoking rate for active duty military is 30.5 percent, with smoking rates highest among personnel ages 18 to 25—especially among soldiers and Ma- rines. The Department of Veterans Affairs estimates that more than 50 percent of all active duty personnel stationed in Iraq smoke.1 This alarming use of tobacco in the military has severe consequences. First, tobacco use compromises military readiness. Studies have found that smoking is one of the best predictors of training failure and smokers also report significantly more stress from military duty than non-smokers. Smoking is also shown to impair a person’s physical capacity, vision, or hearing and increase their chances of physical injury and hospitalization.2 In addition; if a soldier experiences nicotine withdrawal while on active duty; depression, anxiety, and difficulty concentrating on cogitative tasks can develop.3 All of these consequences have a negative impact on the performance of our men and women in our armed forces. Furthermore, the healthcare expenses associated with these behaviors have cost the DOD billions of dollars. The Pentagon spends over $1.6 billion on tobacco-related medical care, increased hospitalization and lost days of work. Lost productivity costs are primarily caused by smoking breaks (estimated at 30 minutes over 220 work days a year) and greater absenteeism. There are also great costs associated with the failure of new recruits to complete basic training. It is clear that more must be done to reduce smoking rates and tobacco use among active duty personnel. Last summer, the prestigious Institute of Medicine (IOM) issued a report entitled, Combating Tobacco Use in Military and Veterans Populations. The panel found ‘‘tobacco control does not have a high priority in DOD or VA.’’ This report, which was requested by both departments, issued a series of recommendations, which the American Lung Association fully supports and asks this Committee to ensure are implemented. The IOM recommendations include commonsense approaches to eliminating the use of tobacco use in the U.S. military. Some of the IOM’s recommendations include: —Phase in tobacco-free policies by starting with military academies, officer-candidate training programs, and university-based reserve officer training corps programs. Then the IOM recommends new enlisted accessions be required to be tobacco-free, followed by all active-duty personnel; —Eliminate tobacco use on military installations using a phased-in approach; —End the sales of tobacco products on all military installations. Personnel often have access to cheap tobacco products on base, which can serve to start and per- petuate addictions; —Ensure that all DOD healthcare and health promotion staff are trained in the standard cessation treatment protocols; and —Ensure that all DOD personnel have barrier-free access to tobacco cessation services. According to the IOM, the authority for the implementation of all the recommendations should rest with the highest levels of the Department, including the surgeon general of each armed service and the individual installation commander. The American Lung Association asks for the Committee’s leadership to ensure this occurs. The United States military cannot fight two wars without ready and healthy troops to successfully complete each mission. With tobacco use causing a decrease of troop readiness, performance and health, the DOD can no longer afford to stand idly by.

1 Hamlett-Berry, KW, as cited in Beckham, JC et al. Preliminary findings from a clinical demonstration project for veterans returning from Iraq or Afghanistan. Military Medicine. May 2008; 173(5):448–51. 2 Institute of Medicine. Combating Tobacco Use in Military and Veteran Populations. 2009; 3– 4. 3 Institute of Medicine. Combating Tobacco Use in Military and Veteran Populations. 2009; 4. 477

Therefore, the American Lung Association recommends that the Department of Defense implement all recommendations called for in the 2009 IOM report. The IOM has laid out a very careful, scientifically-based road map for the DOD to follow and the American Lung Association strongly urges that its recommendations be implemented without delay. Peer Reviewed Lung Cancer Research Program The American Lung Association strongly supports the Lung Cancer Research Pro- gram (LCRP) in the Congressionally Directed Medical Research Program (CDMRP) and its original intent to research the scope of lung cancer in our military. It is for that reason that we were deeply disappointed by changes made by Congress in fiscal year 2010 to the both the LCRP’s governing language and funding. First, LCRP’s funding was cut by 25 percent—$5 million—which may diminish the effectiveness of this crucial research. We urge this Committee to restore the funding level to the fiscal year 2009 level of $20 million. In addition to the reduced funding, the American Lung Association is troubled by the change in governance language of the LCRP authorized by the Congress last fiscal year. The language change not only has consequences for the LCRP in the future but also hampered the implementation of the 2009 LCRP. We request that the 2011 governing language for the LCRP be returned to its original intent, as directed by the 2009 program: ‘‘These funds shall be for competitive research...Priority shall be given to the development of the integrated components to identify, treat and manage early curable lung cancer’’. Troubling Lung Health Concern in Iraq and Afghanistan The American Lung Association is extremely troubled by reports of soldiers who were exposed to burn pits in Iraq and Afghanistan, and are now returning home with lung illnesses including asthma, chronic bronchitis and sleep apnea. Civilians are also at risk. Emissions from burning waste contain fine particulate matter, sulfur oxides, carbon monoxide, volatile organic compounds, and various irritant gases such as nitro- gen oxides that can scar the lungs. Emissions also contain chemicals that are known or suspected to be carcinogens. For vulnerable populations, such as people with cardiovascular diseases, diabetes, asthma and chronic respiratory disease, exposure to these burn pits is particularly harmful. Even short exposures can kill. However, the health impact of particle pol- lution is not limited to individuals with pre-existing conditions. Healthy, young adults who work outside—such as our young men and women in uniform—are also at higher risk. EPA has just concluded that particulate matter causes heart attacks, asthma attacks, and early death. The particles are extremely small and are unable to be fil- tered out of our respiratory system. Instead, these small particles end up deep in the lungs where they remain for months, causing structural damage and chemical changes. In some cases, the particles can move through the lungs and penetrate the bloodstream. Larger particles will end up in the upper respiratory system, causing coughs. Given what we know about the health effects of burning refuse, the American Lung Association recommends that the DOD begin immediately to find alternatives to this method of waste disposal. It is important that the short- and long-term consequences of exposure to these burn pits be monitored by DOD in conjunction with the VA. Finally, we urge that a national registry be established to track all personnel who were exposed to burn pits while in Iraq and Afghanistan. Conclusion Mr. Chairman, in summary, our nation’s military is the best in the world and we should do whatever necessary to ensure that the lung health needs of our armed services are fully met. We can ill afford to fight a third war against tobacco and unsafe air conditions with their severe consequences. Thank you for this opportunity. Chairman INOUYE. Our next witness is Rear Admiral Casey Coane. Admiral. 478

STATEMENT OF REAR ADMIRAL CASEY COANE, UNITED STATES NAVY (RETIRED), EXECUTIVE DIRECTOR, ASSOCIATION OF THE UNITED STATES NAVY Admiral COANE. Mr. Chairman, Senator Cochran, the Association of the United States Navy is once again very pleased to have this opportunity to testify before you. Our Veterans Service Organization focuses a majority of its legislative activity on personnel issues and the equipment necessary for the Navy to carry out its missions. It is only through the attention of Congress and committees such as yours that we can be sure that the needs of our young men and women are being met. We are grateful to take this particular opportunity to speak to you about equipment. With the pressing personnel needs of the services, it may seem a bit cold for me to be here speaking about ships and aircraft. Nonetheless, the equipment of which I am speaking is vital to the conduct of this war and directly supports the thousands of Navy men and women serving on the ground in Afghanistan, Iraq, or other places in the theater, such as the Horn of Africa. Today, 14,000 Navy people are ashore in Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), including Active Duty and reservists. We are pleased with the increased emphasis that the House has recently shown toward the Navy’s ship building plan in order to meet the Nation’s maritime strategy. We urge the Senate to do the same. I invite the subcommittee’s attention to the recently released Na- tional Guard and Reserve equipment report for fiscal year 2011, signed out by the Assistant Secretary of Defense for Reserve Af- fairs. In the Navy section of this report, the point is made that the Navy has successfully and fully integrated its Reserve component. The significance here is that all the Navy’s overused and aging organic airlift aircraft are in the Reserve component. The Navy Re- serves electronic attack squadron right here at Andrews Air Force Base is a critical and frequently deployed component of the Navy’s arsenal and is badly in need of new F–18G Growler aircraft to replace its aged A–6Bs. The Secretary’s report lists aircraft as the top Navy equipping challenge. The aircraft programs listed are the C–40 replacement for the C–9s, the P–8, the Growlers I mentioned, and the KC–130J airlifters. Our association could not agree more. The issue, as Secretary McCarthy indicates on page 14 of the report, is not just newer aircraft, it is that the current aircraft have aged and turned the maintenance expense curve to the extent that prudent business practices, on behalf of the taxpayer, dictate replacement now. The Navy needs six more C–40s to finish the program, and it needs some of them this year. The P–8 is an on-time, on-budget program to replace aging and grounded P–3s, the backbone of the Navy’s overland reconnaissance effort in theater. Anything that this subcommittee could do to accelerate that program, perhaps by utilization of the NGREA account, would be most beneficial. The Navy and Air Force have testified to the unfunded need for electronic attack aircraft in fiscal year 2012 and beyond. Without 479 the transition of the Navy Reserve squadron to the Growler, the Navy will—and I quote from the report—‘‘lose critical operational and strategic Reserve airborne electronic attack capability and capacity.’’ We urge the subcommittee to ensure this does not happen. The Navy’s 30-year aircraft program, the Naval Aviation Plan 2030, has the requirement for the replacement of the C–130T airlifters with the new KC–130Js. Currently, this essential tactical, intra-theater airlift is operating five aircraft short of its requirement. Each year that the new aircraft is delayed will force the Navy to spend more money to upgrade worn-out aircraft to meet new Eu- ropean aviation aircraft standards without which they cannot fly across Europe. We urge the subcommittee to bring the KC–130J forward in the future year defense plan (FYDP) or by adding to the NGREA account. Again, the Association of the United States Navy thanks the subcommittee for their tireless efforts on behalf of our services and for providing this opportunity to be heard. Thank you. Chairman INOUYE. Thank you very much, Admiral. Do you have any questions? Thank you very much, sir. [The statement follows:]

PREPARED STATEMENT OF REAR ADMIRAL CASEY COANE The Association of the United States Navy (AUSN) recently changed its name as of May 19, 2009. The association, formerly known as the Naval Reserve Association, traces its roots back to 1919 and is devoted solely to service to the Nation, Navy, the Navy Reserve and Navy Reserve officers and enlisted. It is the premier national education and professional organization for Active Duty Navy, Navy Reserve personnel, Veterans of the Navy, families of the Navy, and the Association Voice of the Navy and Navy Reserve. Full membership is offered to all members of the U.S. Navy and Naval Reserve. Association members come from all ranks and components. The Association has active duty, reserve, and veterans from all 50 states, U.S. Territories, Europe, and Asia. Forty-five percent of AUSN membership is active reservists, active duty, while the remaining 55 percent are made up of retirees, veterans, and involved DOD civilians. The National Headquarters is located at 1619 King Street Alexandria, VA. 703–548–5800. Mister Chairman and distinguished members of the Committee, the Association of the United States Navy is very grateful to have the opportunity to testify. Our newly transitioned VSO–MSO association works diligently to educate Con- gress, our members, and the public on Navy equipment, force structure, policy issues, personnel and family issues and Navy veterans. I thank this Committee for the on-going stewardship on the important issues of national defense and, especially, the reconstitution and support of the Navy during wartime. At a time of war, non-partisan leadership sets the example. Your unwavering support for our deployed Service Members in Iraq and Afghani- stan (of which over 14,000 Sailors are deployed at Sea in the AOR and over 10,000 are on the ground—Active and Reserve) and for the world-wide fight against terrorism is of crucial importance. Today’s Sailors watch Congressional actions closely. AUSN would like to highlight some areas of emphasis. As a nation, we need to supply our service members with the critical equipment and support needed for individual training, unit training and combat as well as humanitarian and peacekeeping operations. Additionally, we must never forget the Navy families, reserve members and the employers of these unselfish volunteers— Active and Reserve. In recent years, the Maritime Strategy has been highlighted, debated and dis- puted. We feel this is a time where the Total Navy force needs to be stabilized, strengthened, and be reconstituted—because of the consistent, constant, and increasing National Security crisis in a dangerous world— 480

—Piracy is on the rise in many areas of the world, and especially in the 5th Fleet AOR; —The flow of commerce still remains a top priority for our economy; —Naval engagement and support on the ground, in the air, and on the seas for OIF and OEF has not decreased; —Ever increasing Middle East instability; —Ballistic missile threats (N Korea-Iran) and the Navy requirement to be the front line of defense for missile defense threat; —U.S. Navy response to natural disasters; tsunami, Haiti, Chile, and possible man made disasters (oil spill support); —Humanitarian assistance in the Philippines, Indonesia, and American Samoa; and —Ever increasing and changing Arctic issues. In addition to equipment to accomplish assigned missions, the AUSN believes that the Administration and Congress must make it a high priority to maintain, if not increase, but at least stabilize the end strengths of already overworked, and perhaps overstretched, military forces. This includes the Active Navy and the Navy Reserve. Reductions in manpower are generally for appropriations reasons within the Serv- ice, not because people are not needed and their benefits are not a requirement. Our current maritime history and strategy—requires that our nation must achieve the 313∂ Navy Ships, not decrease them, and there should be a balance between personnel end-strengths and equipment. Carriers, submarines, and Naval Aviation are more relevant than ever—as proven by initial and constant actions in Iraq and Afghanistan and ongoing operations in OIF–OEF and throughout Southwest Asia. Additionally—Navy weapon systems and personnel play a critical role in Natural disasters around the world! Therefore, it is not a time—to cut back. We must fund the Navy for proper shipbuilding and aviation programs which the House this year authorized funds to accomplish. As you know, neither the Navy nor the Navy Reserve has ever been a garrisoned force—but, a deployed force. Nothing has changed in recent contingency operations or wars, except that the Navy’s forces needs equipment as much as anyone. We recognize that there are many issues that need to be addressed by this Com- mittee and this Congress. The Association of the United States Navy supports the Navy’s fiscal year 2011 budget submission and the Unfunded Programs List provided by the Chief of Naval Operations that addressed an increased shipbuilding and increase aircraft procurement to relieve the documented shortages and maintenance requirements. Overwhelmingly, we have heard Service Chiefs, Reserve Chiefs and Senior En- listed Advisors discuss the need and requirement for more and unit equipment for training in order to be ready as well as combat equipment in the field. Navy needs to have equipment and unit cohesion to keep personnel trained. This means—Navy equipment and Navy Reserve equipment with units. Equipment Ownership Issue.—Sharing of equipment has been done in the past. However, nothing could be more of a personnel readiness issue and is ill advised. This issue needs to be addressed if the current National Security Strategy is to succeed. Position.—The overwhelming majority of Navy and Navy Reserve members join to have hands-on experience on equipment. The training and personnel readiness of members depends on constant hands-on equipment exposure. History shows, this can only be accomplished through appropriate equipment, since the training cycles are rarely if ever—synchronized with the training or exercise times or deployment times. Additionally, historical records show that units with unite hardware maintain equipment at higher than average material and often have better training readiness. This is especially true with Navy Reserve units. Current and future war fighting requirements will need these highly qualified units when the Combatant Com- manders require fully ready units. Navy has proven its readiness. The personnel readiness, retention, and training of all members will depend on them having equipment that they can utilize, maintain, train on, and deploy with when called upon. AUSN recommends the Com- mittee strengthen the Navy equipment appropriation as the House has done in the fiscal year 2011 NDAA in order to maintain optimally qualified and trained Navy and Navy Reserve forces. Pay, Promotion, and Pride Pay needs to be competitive. If pay is too low, or expenses too high, a service member knows that time may be better invested elsewhere. The current pay raise 481 discussions of 1.9 percent is woefully inadequate when the Nation considers what service members, Navy members, are doing in defense of this nation. The risks and sacrifices of every service member, to defend this great nation, make it illogical to formulate a direct comparison of civil pay to military pay. It just does not make common sense. Promotions need to be fairly regular, and attainable. Pride is a combination of professionalism, parity and awards: doing the job well with requisite equipment, and being recognized for one’s sacrifices and efforts. Care must be taken that the current tremendous reservoir of operational capability be maintained and not lost due to resource shortages. Officers, Chief Petty Of- ficers, and Petty Officers need to exercise leadership and professional competence to maintain their capabilities. In the current environment of Navy Individual Augmentee in support of ground forces, there is a risk that Navy mid-grade leadership will not be able to flourish due to the extended ground war of OIF and OEF. Having the right equipment is critical to our Maritime Strategy. In summary, we believe the Committee needs to address the following issues for Navy and Navy Reserve in the best interest of our National Security: —Fund the 9 Navy Ships provided for in the House fiscal year 2011 NDAA. —Fund one C–40A for the Navy, per the past years documented request; Navy must replace the C–9s and replace the C–20Gs in Hawaii and Maryland. —Fund the FA–18 E/F and FA–18 E/F Growlers per the House fiscal year 2011 NDAA and include unit assets for Navy Reserve units currently in EA–6B aircraft. —Just as other services are having difficulties with intra theater C–130 assets, the Navy needs to replace their C–130 aircraft with C–130J for the Navy and Navy Reserve. —Increase funding for Naval Reserve equipment in NGREA: Increase Navy Re- serve NGREA by $100 million; and Naval Expeditionary Combat Equipment. For the foreseeable future, we must be realistic about what the unintended consequences are from a high rate of usage. History shows that an Active force and Reserve force are needed for any country to adequately meet its defense requirements, and to enable success in offensive operations. Our Active Duty Navy and the current operational Reserve members are pleased to be making a significant contribution to the nation’s defense as operational forces; however, the reality is that the added stress on Active Navy and the Reserve could pose long term consequences for our country in recruiting, retention, family and employer support. In a time of budget cut discussions, this is not the time to cut end-strengths on an already stressed force. We have already been down this road previously. This issue deserves your attention in pay, maintaining end-strengths, proper equipment, Family Sup- port Programs, Transition Assistance Programs and for the Employer Support for the Guard and Reserve programs. Thank you for your ongoing support of the Nation, the Armed Services, the United States Navy, the United States Navy Reserve, their families, and Navy veterans, and the fine men and women who defend our country. Chairman INOUYE. Our next witness is Ms. Kathy Rentfrow. Ms. Rentfrow.

STATEMENT OF KATHY RENTFROW, VOLUNTEER, DYSTONIA MEDICAL RESEARCH FOUNDATION Ms. RENTFROW. Mr. Chairman and members of the Senate Ap- propriations Defense Subcommittee, thank you for allowing me the opportunity to testify today. My name is Kathy Rentfrow, and I am a volunteer with the Dystonia Medical Research Foundation, or DMRF. The DMRF is a patient-centered, nonprofit organization dedicated to serving dystonia patients and their families. The DMRF works to advance dystonia research, increase dystonia awareness, and provide support for those living with the disorder. More importantly, I am a proud military spouse and the mother of a child suffering from dystonia. Dystonia is a neurological movement disorder that causes muscles to contract and spasm involuntarily. Dystonia is not usually 482 fatal, but it is a chronic disorder whose symptoms vary in degrees of frequency, intensity, disability, and pain. Dystonia can be generalized, affecting all major muscle groups, resulting in twisting, repetitive movements, and abnormal postures, or focal, affecting a specific part of the body, such as the legs, arms, hands, neck, face, mouth, eyelids, or vocal cords. At this time, no known cure exists, and treatment is highly individualized. Patients frequently rely on invasive therapies like botulinum toxin injections or deep brain stimulation, DBS, to help manage their symptoms. At age 6, while our family was stationed in Washington, my daughter Melissa was diagnosed with generalized dystonia at Mad- igan Army Medical Center. What began as muscle spasms in her left shoulder, progressed throughout her entire arm, her right hand, legs, and vocal cords. Now, at age 15, Melissa is luckier than many dystonia patients, and this is in large part to the superior care she receives as a military dependent. Due to my husband’s position as a permanent military professor at the United States Naval Academy, our daughter is able to receive care at Walter Reed Army Medical Center. Melissa responds well to treatment with medications, but still needs to take upwards of 20 pills per day. Unlike many dystonia sufferers, Melissa’s extensive costs are covered by TRICARE. Al- though she does not have use of her left arm, she is able to walk and talk without more invasive treatments like botulinum toxin injections, or DBS. This not only affects Melissa’s quality of life, but also that of our entire family. Dystonia is not a discriminatory condition. It affects people of all backgrounds, and this increasingly includes military personnel. Conservative estimates suggest that dystonia affects no less than 300,000 Americans. However, the incidence of dystonia has seen a noticeable increase since our military forces were deployed to Iraq and Afghanistan. This recent increase is widely considered to be the result of a well-documented link between head injuries, other traumatic injuries, and the onset of dystonia. Until a cure for dystonia can be discovered, it remains vital we learn more about the exact causes of the condition and develop more effective and efficient treatments. Although Federal dystonia research is conducted through a number of medical and scientific agencies, the DOD’s Peer-Reviewed Medical Research Program remains the most essential program in studying dystonia in military and veteran populations. The DMRF has been receiving increasing reports of dystonia from service personnel and family members, as well as increased anecdotal evidence from medical professionals linking dystonia to traumatic brain injury, or TBI. As the subcommittee is aware, TBI has emerged as a trademark injury of the current war efforts in Iraq and Afghanistan, often sustained as the result of improvised explosive devices. More and more, TBI and other traumatic injuries are serving as the catalyst for the onset of dystonia. As military personnel remain deployed for longer periods, we can expect dystonia prevalence in military and veterans populations to increase. 483 Thank you for allowing me the opportunity to address the subcommittee today. As the mother of a child suffering from dystonia and as a military spouse concerned with the well-being of our troops, I hope you will continue to include dystonia as a condition eligible for the DOD Peer-Reviewed Medical Research Program. Chairman INOUYE. May I assure you that the subcommittee will most seriously consider your request. That, I can assure you. Ms. RENTFROW. Thank you. Chairman INOUYE. Do you have any—— Senator COCHRAN. I wish we had more time to go into questions and discussions, but I think you can be assured that we take everybody’s testimony seriously. And we want you all to know that we appreciate your being here and keeping us up to date on the needs that we face through our medical programs in the military. Thank you. [The statement follows:]

PREPARED STATEMENT OF KATHY RENTFROW Mr. Chairman and members of the Senate Appropriations Defense Subcommittee, thank you for allowing me the opportunity to testify before you today. My name is Kathy Rentfrow, and I am a volunteer with the Dystonia Medical Research Founda- tion or ‘‘DMRF’’. The DMRF is a patient-centered nonprofit organization dedicated to serving dystonia patients and their families. The DMRF works to advance dystonia research, increase dystonia awareness, and provide support for those living with the disorder. Most importantly, I am a proud military spouse and the mother of a child suffering from dystonia. Dystonia is a neurological movement disorder that causes muscles to contract and spasm involuntarily. Dystonia is not usually fatal, but it is a chronic disorder whose symptoms vary in degrees of frequency, intensity, disability, and pain. Dystonia can be generalized, affecting all major muscle groups, and resulting in twisting repetitive movements and abnormal postures or focal, affecting a specific part of the body such as the legs, arms, hands, neck, face, mouth, eyelids, or vocal chords. At this time, no known cure exists and treatment is highly individualized. Patients frequently rely on invasive therapies like botulinum toxin injections or deep brain stimulation (DBS) to help manage their symptoms. At age 6, while our family was stationed in Washington State, my daughter Me- lissa was diagnosed with generalized dystonia at Madigan Army Medical Center. What began as muscle spasms in her left shoulder and progressed throughout the entire arm, her right hand, legs, and vocal chords. Now at age 15, Melissa is luckier than many dystonia patients, and this is in large part to the superior care she receives as a military dependent. Due to my husband’s position as a permanent military professor at the U.S. Naval academy, our daughter is able to receive care at Walter Reed Army Medical Center. Melissa responds well to treatment with medications, but still needs to take upwards of 20 pills per day. Unlike many dystonia sufferers, Tricare covers the extensive costs of her medications. Although she does not have use of her left arm, she is able to walk and talk without more invasive treatments like botulinum toxin injections or DBS. Dystonia affects not only Melissa’s quality of life, but also that of our entire family. Dystonia is not a discriminatory condition, as it affects people of all backgrounds and this increasingly includes military personnel. Conservative estimates suggest that dystonia affects no less than 300,000 Americans. However, the incidence of dystonia has seen a noticeable increase since our military forces were deployed to Iraq and Afghanistan. This recent increase is widely considered to be the result of a well documented link between head injuries, other traumatic injuries, and the onset of dystonia. Until a cure for dystonia is discovered, it remains vital we learn more about the exact causes of the condition and develop more effective and efficient treatments for patients. Although Federal dystonia research is conducted through a number of medical and scientific agencies, the DOD’s Peer-Reviewed Medical Research Program remains the most essential program studying dystonia in military and veteran populations. The DMRF has been receiving increasing reports of dystonia from service personnel and family members, as well as increased antidotal evidence from medical professionals linking dystonia to traumatic brain injury or ‘‘TBI’’. As the committee 484 is aware, TBI has emerged as a trademark injury of the current war efforts in Iraq and Afghanistan, often sustained as the result of improvised explosive devices. More and more, TBI and other traumatic injuries are serving as the catalyst for the onset of dystonia. As military personnel remain deployed for longer periods, we can expect dystonia prevalence in military and veterans populations to increase, particularly in combat personnel. Dystonia severity and symptoms can vary dramatically from person to person, often drastically effecting quality of life. A June 2006 article in Military Medicine, titled Post-Traumatic Shoulder Dystonia in an Active Duty Soldier reported that, ‘‘Dystonia after minor trauma can be as crippling as a penetrating wound, with disability that renders the soldier unable to perform his duties.’’ The article goes on to say that although battlefield treatment may not be practical, ‘‘awareness of this disorder [dystonia] is essential to avoid mislabeling, and possibly mistreating, a true neurological disease.’’ The DMRF would like to thank the Subcommittee for adding dystonia to the list of conditions eligible for study under the DOD Peer-Reviewed Medical Research Pro- gram in the fiscal year 2010 DOD Appropriations bill. Unlike other Federally funded medical research programs, conditions eligible for study through the Peer-Re- viewed Medical Research Program must affect members of the armed services and their families. As traumatic injuries and dystonia among service personnel increases, it is critical that we develop a better understand of the mechanisms connecting TBI and dystonia. We urge Congress to maintain dystonia as a condition deemed eligible for study through the Peer-Reviewed Medical Research Program, as the number of current military members and veterans with dystonia swells. Thank you again for allowing me the opportunity to address the Subcommittee today. As the mother of a child suffering from dystonia, and as a military spouse concerned with the well-being of our troops and veterans, I hope you will continue to include dystonia as condition eligible for study under the DOD Peer-Reviewed Medical Research Program. Chairman INOUYE. And now, may I recognize Mr. John Davis. Mr. Davis. STATEMENT OF JOHN R. DAVIS, DIRECTOR, LEGISLATIVE PROGRAMS, FLEET RESERVE ASSOCIATION Mr. DAVIS. Thank you, Mr. Chairman. My name is John Davis, and I want to thank you for the opportunity to express the views of the Fleet Reserve Association. The association appreciates the administration’s second consecutive request for full funding of the TRICARE program without a fee increase. We believe we need to look at other cost-saving options first before looking at a TRICARE fee increase. Further, FRA believes that raising TRICARE fees during wartime would send the wrong message that could impact recruitment and retention. A recent FRA survey indicates that more than 90 percent of all Active Duty, retired, and veteran respondents cited healthcare as their top quality of life benefit. FRA welcomes the administration’s focus on creating an electronic health record for service members that can follow them to the Department of Veterans Affairs (VA) and for the rest of their lives. Oversight notwithstanding, adequate funding for an effective delivery system between DOD and VA to guarantee a seamless transition and quality services for wounded personnel is very important to our membership. The association appreciates President Obama’s support for authorizing chapter 61 retirees to receive full military retired pay and full veterans’ disability compensation. FRA continues to seek authorization of funding of full concurrent receipt for all disabled retirees. An FRA survey indicates that more than 70 percent of military retirees cite concurrent receipt among their top priorities. 485 The association strongly supports the fiscal year 2011 budget request of $408 million to cover the first phase of the 5-year cost of concurrent receipt for chapter 61 beneficiaries that are 90 percent or more disabled and supports provisions in the so-called ‘‘tax extenders bill’’—that is H.R. 4213—that expands the concurrent receipt of military retired pay and the VA disability compensation. Family support is also important and should include full funding for compensation, training and certification, and respite care for family members functioning as full-time caregivers for wounded warriors. The recently enacted Caregivers and Veterans Omnibus Health Services Act—that is S. 1963—and parallel provision in the Senate version of the Defense authorization bill improves compensation, training, and assistance for caregivers of severely disabled Active Duty service members. And if authorized, FRA supports funding for these enhancements. FRA strongly supports the funding of a 1.9 percent pay increase, which is 0.5 percent above the administration’s request for fiscal year 2011. Pay increases in recent years have helped close the pay gap and contributed to improved morale, readiness, and retention. Pay and benefits must reflect the fact that military service is very different from the work in the private sector. If authorized, FRA supports funding retroactive eligibility for early retirement benefits to include reservists who have supported contingency operations since 9/11/2001. The 2008 Defense authorization act reduces the Reserve retirement age, which is age 60, by 3 months for each cumulative 90 days ordered to Active Duty. This applies only to servicemen after the effective date of legislation, which is January 28, 2008, and leaves out more than 600,000 reservists mobilized since 9/11. Again, thank you for allowing FRA to submit its views to the subcommittee. Chairman INOUYE. Mr. Davis, I can assure you that the subcommittee is well aware that the men and women who serve in uniform are all volunteers. And as far as we are concerned, anyone who is willing to stand in harm’s way on our behalf deserves the very best. We give it the highest priority. Thank you very much. Senator COCHRAN. Thank you very much, Mr. Chairman. We appreciate your testimony and the reminders of the real-life challenges that many of our servicemen and women face, and I hope this subcommittee can respond in a way that shows our concern and support for their efforts and their unselfish service. [The statement follows:]

PREPARED STATEMENT OF JOHN R. DAVIS

THE FRA The Fleet Reserve Association (FRA) is the oldest and largest enlisted organization serving active duty, Reserves, retired and veterans of the Navy, Marine Corps, and Coast Guard. It is Congressionally Chartered, recognized by the Department of Veterans Affairs (VA) as an accrediting Veteran Service Organization (VSO) for claim representation and entrusted to serve all veterans who seek its help. In 2007, FRA was selected for full membership on the National Veterans’ Day Committee. FRA was established in 1924 and its name is derived from the Navy’s program for personnel transferring to the Fleet Reserve or Fleet Marine Corps Reserve after 20 or more years of active duty, but less than 30 years for retirement purposes. Dur- 486 ing the required period of service in the Fleet Reserve, assigned personnel earn re- tainer pay and are subject to recall by the Secretary of the Navy. FRA’s mission is to act as the premier ‘‘watch dog’’ organization in maintaining and improving the quality of life for Sea Service personnel and their families. FRA is a leading advocate on Capitol Hill for enlisted active duty, Reserve, retired and veterans of the Sea Services. The Association also sponsors a National Americanism Essay Program and other recognition and relief programs. In addition, the newly established FRA Education Foundation oversees the Association’s scholarship program that presents awards totaling nearly $100,000 to deserving students each year. The Association is also a founding member of The Military Coalition (TMC), a 34- member consortium of military and veteran’s organizations. FRA hosts most TMC meetings and members of its staff serve in a number of TMC leadership roles. FRA celebrated 85 years of service in November 2009. For over eight decades, dedication to its members has resulted in legislation enhancing quality of life programs for Sea Services personnel, other members of the uniformed services plus their families and survivors, while protecting their rights and privileges. CHAMPUS, now TRICARE, was an initiative of FRA, as was the Uniformed Serv- ices Survivor Benefit Plan (USSBP). More recently, FRA led the way in reforming the REDUX Retirement Plan, obtaining targeted pay increases for mid-level enlisted personnel, and sea pay for junior enlisted sailors. FRA also played a leading role in advocating recently enacted predatory lending protections and absentee voting reform for service members and their dependents. FRA’s motto is: ‘‘Loyalty, Protection, and Service.’’

OVERVIEW Mr. Chairman, the Fleet Reserve Association salutes you, members of the Sub- committee, and your staff for the strong and unwavering support of funding essential programs for active duty, Reserve Component, and retired members of the uniformed services, their families, and survivors. The Subcommittee’s work in funding important programs has greatly enhanced care and support for our wounded warriors, improved military pay, eliminated out-of-pocket housing expenses, improved healthcare, and enhanced other personnel, retirement and survivor programs. This funding is critical in maintaining readiness and is invaluable to our Armed Forces engaged in a long and protracted two front war, sustaining other operational commitments and fulfilling commitments to those who’ve served in the past. But more still needs to be done. A constant high priority for FRA is full funding of the Defense Health Program (DHP) to ensure quality care for active duty, retirees, Reservists, and their families. FRA’s other 2010 priorities include annual active duty pay increases that are at least a half percent above the Employment Cost Index (ECI), to help close the pay gap between active duty and private sector pay, full concurrent receipt of military retired pay and VA disability compensation, retirement credit for reservists that have been mobilized since September 1, 2001, enhanced family readiness via improved communications and awareness initiatives related to benefits and quality of life programs, and introduction and enactment of legislation to eliminate inequities in the Uniformed Service Former Spouses Protection Act (USFSPA). The Administration’s fiscal year 2011 proposed budget for a second consecutive year fully funds the DHP budget without shifting additional cost burdens to military retirees. FRA appreciates this and strongly supports efforts to fully implement electronic health records that will follow service members as they transition from DOD to the VA. FRA also supports additional improvements in concurrent receipt to expand the number of disabled military retirees receiving both their full military retired pay and VA disability compensation. The fiscal year 2011 budget also calls for a 1.4-percent active duty pay increase that equals the Employment Cost Index (ECI). The budget further increases care for wounded warriors by 5.8 percent, enhances family support by 3 percent, adds $87 million to child development centers, and boosts family counseling/relocation assistance by $37 million over the current fiscal year 2010 budget. As Operation Iraqi Freedom ends and troops depart from Iraq, some will be urging reductions in spending, despite the need to bolster efforts in Afghanistan and other operational commitments around the world. FRA understands the budgetary concerns generated by the current economic slowdown and other challenges but advocates that cutting the DOD budget during the Global War on Terror would be short sighted and that America needs a defense budget that will provide adequate spending levels for both ‘‘benefits and bullets.’’ 487

HEALTH CARE Healthcare is especially significant to all FRA Shipmates regardless of their status and protecting and/or enhancing this benefit is the Association’s top legislative priority. A recently released FRA survey indicates that nearly 90 percent of all active duty, Reserve, retired, and veteran respondents cited healthcare access as a critically important quality-of-life benefit associated with their military service. From 2006–2008 retirees under age 65 were targeted by DOD to pay significantly higher healthcare fees. Many of these retirees served before the recent pay and benefit enhancements were enacted and receive significantly less retired pay than those serving and retiring in the same pay grade with the same years of service today. Promises were made to them about healthcare for life in return for a career in the military with low pay and challenging duty assignments and many believe they are entitled to free healthcare for life. Efforts to enact a national healthcare reform coupled with inaccurate and widespread information on the associated impact on retiree healthcare benefits has created unease and a sense of uncertainty for our members. FRA opposes any effort to integrate TRICARE and VA healthcare into any national healthcare program. The Association is concerned about proposed Medicare spending cuts associated with reform legislation and scheduled cuts for physician reimbursement rates for Medi- care and TRICARE beneficiaries that could negatively impact availability of care, and quality of services. It’s also important to note that healthcare costs both in the military and throughout society have continued to increase faster than the Con- sumer Price Index (CPI) making this a prime target for those wanting to cut the DOD budget. FRA strongly supports fully funding the TRICARE program and ‘‘The Military Re- tirees’ Health Care Protection Act’’ (H.R. 816) sponsored by Representatives Chet Edwards (TX) and Walter Jones (NC). The legislation would prohibit DOD from increasing TRICARE fees, specifying that the authority to increase TRICARE fees exists only in Congress. DOD must continue to investigate and implement other TRICARE cost-saving options as an alternative to shifting costs to retiree beneficiaries. FRA notes progress in this area in expanding use of the mail order pharmacy program, Federal pricing for prescription drugs, a pilot program of preventative care for TRICARE beneficiaries under age 65, and elimination of co-pays for certain preventative services. The Association believes these efforts will prove beneficial in slowing military healthcare spending in the coming years.

CONCURRENT RECEIPT The Association appreciates President Obama’s support for authorizing Chapter 61 retirees to receive their full military retired pay and veteran’s disability compensation and continues to seek timely and comprehensive implementation of legislation that authorizes the full concurrent receipt for all disabled retirees. As with last year’s budget, the proposed fiscal year 2011 budget does not provide funding or identify spending offsets for these improvements and does not comply with House budgeting rules. The above referenced FRA survey indicates that more than 70 percent of military retirees cite concurrent receipt among their top priorities. The Asso- ciation strongly supports the fiscal year 2011 budget request of $408 million to cover the first phase of the 5-year cost for concurrent receipt for Chapter 61 beneficiaries that are 90 percent or more disabled and supports the provisions in the so-called ‘‘tax-extenders’’ bill (H.R. 4213) that expands the concurrent receipt of military retired pay and VA disability compensation. The measure would authorize service members who are medically retired with less than 20 years of service (Chapter 61 retirees) and have a disability rating of 90 to 100 percent to receive both payments, without offset, starting on January 1, 2011. The following year concurrent receipt would be expanded to those with 70- to 80-percent disability ratings.

WOUNDED WARRIORS FRA appreciates the substantial Wounded Warriors provisions in the fiscal year 2008 National Defense Authorization Act (NDAA). Despite jurisdictional challenges, considerable progress has been made in this area. However, the enactment of authorizing legislation is only the first step in helping wounded warriors. Sustained funding is also critical for successful implementation. Jurisdictional challenges notwithstanding adequate funding for an effective delivery system between DOD and VA to guarantee seamless transition and quality services for wounded personnel, particularly those suffering from Post Traumatic Stress Disorder (PTSD) and Trau- matic Brain Injuries (TBI) is very important to our membership. Family support is 488 also critical for success, and should include full funding for compensation, training, and certification, and respite care for family members functioning as full-time caregivers for wounded warriors. FRA supported the recently enacted ‘‘Caregivers and Veterans Omnibus Health Services Act’’ (S. 1963), and parallel legislation included in the Senate’s version of the fiscal year 2011 Defense Authorization bill (S. 3454) to improve compensation, training and assistance for caregivers of several disabled active-duty service members.

ADEQUATE PERSONNEL END STRENGTH Funding for adequate service end strengths is essential to success in Iraq and Af- ghanistan and to sustaining other operations vital to our national security. FRA notes the Marine Corps’ success in attaining its current end strength level and strongly supports the proposed Navy end strength increase in 2011. A recent Navy Times story entitled ‘‘Sailor shortage,’’ cites too much work to do in the Navy and not enough people to do it—and lists the associated effects which include little time for rest, fewer people to maintain and repair shipboard equipment, crew members with valuable skills being pulled for other jobs and not replaced and lower material ship readiness. The strain of repeated deployments continues and is also related to the adequacy of end strengths—and FRA is tracking disturbing indicators of the effects which include increased prescription drug and alcohol use, increasing mental healthcare appointments, alarming suicide rates plus more military divorces. Stress on service members and their families was addressed during a recent Senate Personnel Sub- committee hearing along with serious and continuing concerns about associated effects which can include morale, readiness and retention challenges. FRA urges this distinguished Subcommittee to ensure funding for adequate end strengths and people programs consistent with the Association’s DOD funding goal of at least 5 percent of the GDP.

ACTIVE DUTY PAY IMPROVEMENTS Our Nation is at war and there is no more critical morale issue for active duty warriors than adequate pay. This is reflected in the more than 96 percent of active duty respondents to FRA’s recent survey indicating that pay is ‘‘very important.’’ The Employment Cost Index for fiscal year 2011 is 1.4 percent and based on statistics from 15 months before the effective date of the proposed active duty pay increase. The Association appreciates the strong support from this distinguished Sub- committee in funding pay increases that have reduced the 13.5 percent pay gap (1999) to the current level of 2.4 percent. In addition, FRA notes that even with a fiscal year 2011 pay increase that is 0.5 percent above the ECI, the result will be the smallest pay hike since 1958. FRA urges the Subcommittee to continue the fund pay increases at least 0.5 percent above the ECI until the remaining 2.4 percent pay gap is eliminated.

RESERVE ISSUES FRA stands foursquare in support of the Nation’s Reservists. Due to the demands of the War on Terror, Reserve units are now increasingly mobilized to augment active duty components. As a result, the Reserve component is no longer a strategic Reserve, but is an operational Reserve that is an integral part of the total force. And because of these increasing demands, including missions abroad over longer periods of time, it is essential to improve compensation and benefits to retain currently serving personnel and attract quality recruits. Retirement.—If authorized, FRA supports funding retroactive eligibility for the early retirement benefit to include Reservists who have supported contingency operations since 9/11/2001 (H.R. 208/S. 831/S.644). The fiscal year 2008 Defense Author- ization Act (H.R. 4986) reduces the Reserve retirement age (age 60) by 3 months for each cumulative 90-days ordered to active duty after the effective date (January 28, 2008) leaving out more than 600,000 Reservists mobilized since 9/11 for duty in Afghanistan and Iraq. Family Support.—FRA supports resources to allow increased outreach to connect Reserve families with support programs. This includes increased funding for family readiness, especially for those geographically dispersed, not readily accessible to military installations, and inexperienced with the military. Unlike active duty families who often live near military facilities and support services, most Reserve families live in civilian communities where information and support is not readily available. Congressional hearing witnesses have indicated that many of the half million mobilized Guard and Reserve personnel have not received transition assistance 489 services they and their families need to make a successful transition back to civilian life.

CONCLUSION FRA is grateful for the opportunity to present these funding recommendations to this distinguished Subcommittee. The Association reiterates its profound gratitude for the extraordinary progress this Subcommittee has made in funding a wide range of military personnel and retiree benefits and quality-of-life programs for all uniformed services personnel and their families and survivors. Thank you again for the opportunity to present the FRA’s views on these critically important topics. Chairman INOUYE. I would like to thank the first panel, and may I now call upon the second panel made up of Mr. Terry C. Wicks, Ms. Karen Mason, Ms. Katie Savant, and Dr. Dan Putka. Welcome, and may I first call upon Mr. Terry Wicks.

STATEMENT OF TERRY C. WICKS, CERTIFIED REGISTERED NURSE AN- ESTHETIST, MHS, AMERICAN ASSOCIATION OF NURSE ANES- THETISTS Mr. WICKS. Chairman Inouye, Vice Chairman Cochran, good morning. My name is Terry Wicks. Chairman INOUYE. Will you put on the mike, please? Mr. WICKS. My name is Terry Wicks. I am past president of the 40,000 member American Association of Nurse Anesthetists, and while on Active Duty in the military, I also served as president of the Hawaii Association of Nurse Anesthetists. The quality of healthcare America provides our servicemen and servicewomen and their dependents has long been this subcommittee’s high priority. Today, I report to you the contributions that certified registered nurse anesthetists, or CRNAs, make toward our services’ mission, and I will also provide you our recommendations to further improve military healthcare for these challenging times. I also ask unanimous consent that our written statement be entered in the record. Chairman INOUYE. Without objection. Mr. WICKS. America’s CRNAs provide some 32 million anes- thetics annually in every healthcare setting requiring anesthesia care, and we provide that care safely. The Institute of Medicine reported in 2000 that anesthesia is 50 times safer than it was in the early 1980s. For the United States armed forces, CRNAs are particularly critical. In 2009, over 500 Active Duty and more than 750 reservist CRNAs provided anesthesia care indispensable to our armed forces’ current mission. Not long ago, one CRNA, Major General Gale Pollock, served as acting Surgeon General of the United States Army. Today, CRNAs serve in major military hospitals, at educational institutions, aboard ships, and in isolated bases abroad and at home. And as members of forward surgical teams, they serve as close to the tip of the spear as they can be. In most of these environments, CRNAs provide anesthesia services alone—without anesthesiologists—enabling surgeons and other clinicians to safely deliver lifesaving care. But in recent years, the number of CRNAs in the armed forces has fallen below the number needed. The private market for CRNA services is very, very strong, and the military has struggled to compete. 490 The services, this subcommittee, and the authorizing committees have responded with increased benefits to CRNAs, incentive specialty pay, and the Health Professions Loan Repayment Program, focusing on incentives for multi-year agreements. The profession of nurse anesthesia has likewise responded. The Counsel on Certification of Nurse Anesthetists reported that in 2009, our schools produced 2,228 graduates, double the number since 2000. And 2,386 nurse anesthetists were certified. That growth is expected to continue. The Counsel on Accreditation of Nurse Anesthesia Educational Programs projects that CRNA schools will produce over 2,400 graduates in 2010. These combined actions have helped strengthen the services’ readiness and the quality of healthcare available to our servicemen and servicewomen. So our first recommendation to you is to extend and strengthen the successful ISP program for CRNAs. The authorizing committee has extended the ISP program. We would encourage this subcommittee to continue funding ISP levels sufficient for the services to recruit and retain the CRNAs needed for the mission. Our second recommendation is for the subcommittee to encourage all services to adopt a joint scope of practice. Standard practices across the services enhance patient safety and the quality of healthcare for our servicemen and women. The Navy, in particular, has made a great deal of progress toward adopting a joint scope of independent practitioners. We encourage its adoption in all services. Like our military CRNAs that serve each and every day, the American Association of Nurse Anesthetists stands ready to work with Congress to ensure that all of our military men and women get the care that they need and deserve. Thank you, and I would be happy to take any questions. Chairman INOUYE. Thank you very much. I can assure that this subcommittee is well aware of the shortage of nurse anesthetists. We are also aware that if it weren’t for nurse anesthetists, we won’t have any anesthesia in rural America because 85 percent of that is administered by nurse anesthetists. Mr. WICKS. Yes, sir. Chairman INOUYE. So we are going to do our very best. Mr. WICKS. Thank you. Chairman INOUYE. Do you have any questions? I thank you very much, sir. [The statement follows:]

PREPARED STATEMENT OF TERRY C. WICKS Chairman Inouye, Ranking Member Cochran, and Members of the Subcommittee: The American Association of Nurse Anesthetists (AANA) is the professional association that represents over 40,000 Certified Registered Nurse Anesthetists (CRNAs) across the United States, including more than 500 active duty and over 750 reservists in the military reported in 2009. The AANA appreciates the opportunity to provide testimony regarding CRNAs in the military. We would also like to thank this committee for the help it has given us in assisting the Department of Defense (DOD) and each of the services to recruit and retain CRNAs.

CRNAS AND THE ARMED FORCES: A TRADITION OF SERVICE Let us begin by describing the profession of nurse anesthesia, and its history and role with the Armed Forces of the United States. 491

In the administration of anesthesia, CRNAs perform the same functions as anesthesiologists and work in every setting in which anesthesia is delivered including hospital surgical suites and obstetrical delivery rooms, ambulatory surgical centers, health maintenance organizations, and the offices of dentists, podiatrists, ophthal- mologists, and plastic surgeons. Today, CRNAs administer some 30 million anes- thetics given to patients each year in the United States. Nurse anesthetists are also the sole anesthesia providers in the vast majority of rural hospitals, assuring access to surgical, obstetrical and other healthcare services for millions of rural Americans. Our tradition of service to the military and our Veterans is buttressed by our personal, professional commitment to patient safety, made evident through research into our practice. In our professional association, we state emphatically ‘‘our members’ only business is patient safety.’’ Safety is assured through education, high standards of professional practice, and commitment to continuing education. Having first practiced as registered nurses, CRNAs are educated to the master’s degree level, and some to the doctoral level, and meet the most stringent continuing education and recertification standards in the field. Thanks to this tradition of advanced education and clinical practice excellence, we are humbled and honored to note that anesthesia is 50 times safer now than in the early 1980s (National Acad- emy of Sciences, 2000). Research further demonstrates that the care delivered by CRNAs, physician anesthesiologists, or by both working together yields similar patient safety outcomes. In addition to studies performed by the National Academy of Sciences in 1977, Forrest in 1980, Bechtoldt in 1981, the Minnesota Department of Health in 1994, and others, Dr. Michael Pine, MD, MBA, recently concluded once again that among CRNAs and physician anesthesiologists, ‘‘the type of anesthesia provider does not affect inpatient surgical mortality’’ (Pine, 2003). Thus, the practice of anesthesia is a recognized specialty in nursing and medicine. Most recently, a study published in Nursing Research confirmed obstetrical anesthesia services are extremely safe, and that there is no difference in safety between hospitals that use only CRNAs compared with those that use only anesthesiologists (Simonson et al, 2007). Both CRNAs and anesthesiologists administer anesthesia for all types of surgical procedures from the simplest to the most complex, either as single providers or together.

NURSE ANESTHETISTS IN THE MILITARY Since the mid-19th century, our profession of nurse anesthesia has been proud and honored to provide anesthesia care for our past and present military personnel and their families. From the Civil War to the present day, nurse anesthetists have been the principal anesthesia providers in combat areas of every war in which the United States has been engaged. Military nurse anesthetists have been honored and decorated by the U.S. and foreign governments for outstanding achievements, resulting from their dedication and commitment to duty and competence in managing seriously wounded casualties. In World War II, there were 17 nurse anesthetists to every one anesthesiologist. In Vietnam, the ratio of CRNAs to physician anesthetists was approximately 3:1. Two nurse anesthetists were killed in Vietnam and their names have been engraved on the Vietnam Memorial Wall. During the Panama strike, only CRNAs were sent with the fighting forces. Nurse anesthetists served with honor during Desert Shield and Desert Storm. Military CRNAs also provide critical anesthesia support to humanitarian missions around the globe in such places as Bosnia and Somalia. In May 2003, approximately 364 nurse anesthetists had been deployed to the Middle East for the military mission for ‘‘Operation Iraqi Freedom’’ and ‘‘Operation Enduring Freedom.’’ When Presi- dent George W. Bush initiated ‘‘Operation Enduring Freedom,’’ CRNAs were immediately deployed. With the new special operations environment new training was needed to prepare our CRNAs to ensure military medical mobilization and readiness. Brigadier General Barbara C. Brannon, Assistant Surgeon General, Air Force Nursing Services, testified before this Senate Committee on May 8, 2002, to provide an account of CRNAs on the job overseas. She stated, ‘‘Lt. Col. Beisser, a certified registered nurse anesthetist (CRNA) leading a Mobile Forward Surgical Team (MFST), recently commended the seamless interoperability he witnessed during treatment of trauma victims in Special Forces mass casualty incident.’’ Data gathered from the U.S. Armed Forces anesthesia communities reveal that CRNAs have often been the sole anesthesia providers at certain facilities, both at home and while forward deployed. For decades CRNAs have staffed ships, isolated U.S. bases, and forward surgical teams without physician anesthesia support. The U.S. Army Joint Special Operations Command Medical Team and all Army Forward Surgical Teams are staffed solely by CRNAs. Military CRNAs have a long proud his- 492 tory of providing independent support and quality anesthesia care to military men and women, their families and to people from many nations who have found themselves in harms way. In the current mission, CRNAs are deployed all over the world, on land and at sea. This committee must ensure that we retain and recruit CRNAs for now and in the future to serve in these military deployments overseas. This committee must ensure that we retain and recruit CRNAs now and in the future to serve in these military overseas deployments and humanitarian efforts, and to ensure the maximum readiness of America’s armed services.

NURSE ANESTHESIA PROVIDER SUPPLY AND DEMAND: SOLUTIONS FOR RECRUITMENT AND RETENTION In all of the Services, maintaining adequate numbers of active duty CRNAs is of utmost concern. For several years, the number of CRNAs serving in active duty fell short of the number authorized by the Department of Defense (DOD). This is further complicated by strong demand for CRNAs in both the public and private sectors. It is essential to understand that while there is strong demand for CRNA services in the public and private healthcare sectors, the profession of nurse anesthesia is working effectively to meet this workforce challenge. The AANA anticipates growing demand for CRNAs. Our evidence suggests that while vacancies exist, the demand for anesthesia professionals can be met if appropriate actions are taken. As of Janu- ary 2010, there are 108 accredited nurse anesthesia schools to support the profession, and the number of qualified registered nurses applying to these schools continues to climb. The growth in the number of schools, number of applicants, and production capacity has yielded significant growth in the number of student nurse anesthetists graduating and being certified into the profession. The Council on Cer- tification of Nurse Anesthetists reports that in 2009 our schools produced 2,228 graduates, a 66 percent increase since 2003, and 2,386 nurse anesthetists became certified. This growth is expected to continue. The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) projects that the 108 CRNA schools will produce 2,430 graduates in 2010. This Committee can greatly assist in the effort to attract and maintain essential numbers of nurse anesthetists in the military by their support to increase special pays.

INCENTIVE SPECIAL PAY FOR NURSES According to a March 1994 study requested by the Health Policy Directorate of Health Affairs and conducted by DOD, a large pay gap existed between annual civilian and military pay in 1992. This study concluded, ‘‘this earnings gap is a major reason why the military has difficulty retaining CRNAs.’’ In order to address this pay gap, in the fiscal year 1995 Defense Authorization bill Congress authorized the implementation of an increase in the annual Incentive Special Pay (ISP) for nurse anesthetists from $6,000 to $15,000 for those CRNAs no longer under service obligation to pay back their anesthesia education. Those CRNAs who remained obligated receive the $6,000 ISP. Both the House and Senate passed the fiscal year 2003 Defense Authorization Act conference report, H. Rept. 107–772, which included an ISP increase to $50,000. The report included an increase in ISP for nurse anesthetists from $15,000 to $50,000. The AANA is requesting that this committee fund the ISP at $50,000 for all the branches of the armed services to retain and recruit CRNAs now and into the future. Per the testimony provided in 2006 from the three services’ Nurse Corps leaders, the AANA is aware that there is an active effort with the Surgeons General to closely evaluate and adjust ISP rates and policies needed to support the recruitment and retention of CRNAs. In 2006, Major General Gale Pollock, MBA, MHA, MS, CRNA, FACHE, Deputy Surgeon General, Army Nurse Corps of the U.S. Army stated in testimony before this Subcommittee, ‘‘I am particularly concerned about the retention of our certified registered nurse anesthetists (CRNAs). Our inventory of CRNAs is currently at 73 percent. The restructuring of the incentive special pay program for CRNAs last year, as well as the 180 (day)-deployment rotation policy were good first steps in stemming the loss of these highly trained providers. We are working closely with the Surgeon General’s staff to closely evaluate and adjust rates and policies where needed.’’ There have been positive results from the Nurse Corps and Surgeons General initiatives to increase incentive special pays for CRNAs. In testimony before the House Armed Services Committee in 2007, Gen. Pollock stated, ‘‘We have...increased the Incentive Special Pay (ISP) Certified Registered Nurse Anesthetist, and ex- 493 panded use of the Health Professions Loan Repayment Program (HPLRP). The...Nurse Anesthetist bonuses have been very successful in retaining these providers who are critically important to our mission on the battlefield.’’ She also stated in that same statement, ‘‘In 2004, we increased the multi-year bonuses we offer to Certified Registered Nurse Anesthetists with emphasis on incentives for multi-year agreements. A year’s worth of experience indicates that this increased bonus, 180-day deployments, and a revamped Professional Filler system to improve deployment equity is helping to retain CRNAs.’’ There still continues to be high demand for CRNAs in the healthcare community leading to higher incomes widening the gap in pay for CRNAs in the civilian sector compared to the military. However, the ISP and other incentives the services are providing CRNAs has helped close that gap the past 3 years, according to the most recent AANA membership survey data. In civilian practice, all additional skills, experience, duties and responsibilities, and hours of work are compensated for mone- tarily. Additionally, training (tuition and continuing education), healthcare, retirement, recruitment and retention bonuses, and other benefits often equal or exceed those offered in the military. Therefore, it is vitally important that the Incentive Special Pay (ISP) be supported to ensure retention of CRNAs in the military. AANA thanks this Committee for its support of the annual ISP for nurse anesthetists. AANA strongly recommends the continuation in the annual funding for ISP at $50,000 or more for fiscal year 2011, which recognizes the special skills and advanced education that CRNAs bring to the DOD healthcare system, and supports the mission of our U.S. Armed Forces.

BOARD CERTIFICATION PAY FOR NURSES Included in the fiscal year 1996 Defense Authorization bill was language authorizing the implementation of a board certification pay for certain clinicians who are not physicians, including advanced practice nurses. AANA is highly supportive of board certification pay for all advanced practice nurses. The establishment of this type of pay for nurses recognizes that there are levels of excellence in the profession of nursing that should be recognized, just as in the medical profession. In addition, this pay may assist in closing the earnings gap, which may help with retention of CRNAs. While many CRNAs have received board certification pay, some remain ineligible. Since certification to practice as a CRNA does not require a specific master’s degree, many nurse anesthetists have chosen to diversify their education by pursuing an advanced degree in other related fields. But CRNAs with master’s degrees in education, administration, or management are not eligible for board certification pay since their graduate degree is not in a clinical specialty. Many CRNAs who have non-clinical master’s degrees either chose or were guided by their respective services to pursue a degree other than in a clinical specialty. The AANA encourages DOD and the respective services to reexamine the issue of restricting board certification pay only to CRNAs who have specific clinical master’s degrees.

DOD/VA RESOURCE SHARING: U.S. ARMY-VA JOINT PROGRAM IN NURSE ANESTHESIA, FORT SAM HOUSTON, SAN ANTONIO, TEXAS The establishment of the joint U.S. Army-VA program in nurse anesthesia education at the U.S. Army Graduate Program in Anesthesia Nursing, Fort Sam Hous- ton, in San Antonio, Texas holds the promise of making significant improvements in the VA CRNA workforce, as well as improving retention of DOD registered nurses in a cost effective manner. The current program utilizes existing resources from both the Department of Veterans Affairs Employee Incentive Scholarship Pro- gram (EISP) and VA hospitals to fund tuition, books, and salary reimbursement for student registered nurse anesthetists (SRNAs). This joint program also serves the interests of the Army. This VA nurse anesthesia program started in June 2004 with three openings for VA registered nurses to apply to and earn a Master of Science in Nursing (MSN) in anesthesia granted through the University of Texas Houston Health Science Cen- ter. In the future, the program is granting degrees through the Northeastern Uni- versity Bouve College of Health Sciences nurse anesthesia educational program in Boston, Massachusetts. At a time of increased deployments in medical military personnel, this type of VA–DOD partnership is a cost-effective model to fill these gaps in the military healthcare system. At Fort Sam Houston, the VA faculty director has covered her Army colleagues’ didactic classes when they are deployed at a moments notice. This benefits both the VA and the DOD to ensure the nurse anesthesia students are trained and certified in a timely manner to meet their workforce obligation to the Federal government as anesthesia providers. We are pleased to note that 494 the Department of Veterans’ Affairs Acting Deputy Under Secretary for Health and the U.S. Army Surgeon General approved funding to start this VA nurse anesthesia school in 2004. In addition, the VA director has been pleased to work under the direction of the Army program director LTC Joseph O’Sullivan, CRNA, Ph.D., to further the continued success of this U.S. Army-VA partnership. With modest levels of additional funding in the VA EISP, this joint U.S. Army-VA nurse anesthesia education initiative can grow and thrive, and serve as a model for meeting other VA workforce needs, particularly in nursing.

CONCLUSION In conclusion, the AANA believes that the recruitment and retention of CRNAs in the armed services is of critical concern. By Congress supporting these efforts to recruit and retain CRNAS, the military is able to meet the mission to provide benefit care and deployment care—a mission that is unique to the military. The AANA would also like to thank the Surgeons General and Nurse Corp leadership for their support in meeting the needs of the profession within the military workforce. Last, we commend and thank this committee for their continued support for CRNAs in the military. Thank you. If you have further questions, please contact the AANA Federal Gov- ernment Affairs Office at 202–484–8400. Chairman INOUYE. And our next witness is Ms. Karen Mason. STATEMENT OF KAREN MASON, REGISTERED NURSE, OVARIAN CAN- CER NATIONAL ALLIANCE Ms. MASON. Good morning, Mr. Chairman and Mr. Vice Chair- man. I am honored to appear before you in support of the Ovarian Cancer National Alliance’s request of $30 million for the Depart- ment of Defense Ovarian Cancer Research Program. My name is Karen Mason, and I am an intensive care nurse from Pitman, New Jersey. I also serve as an integration panel member for the Ovarian Cancer Research Program, which I will refer to as the OCRP for the remainder of my testimony. As a 9 year survivor of late-stage ovarian cancer, I feel a strong sense of responsibility to my community and sit before you today as the voice of all women with this disease—past, present, and future. During my 9 years of survivorship, I have befriended many women who also had late-stage ovarian cancer. One by one, I have watched most of these women die. Today, in the Delaware Valley, I know of no other woman diagnosed at a late stage who has survived as long as I have. I still speak to women newly diagnosed to offer them hope, but now I must hold a piece of my heart in reserve. It is my hope that today I can beseech you to share this responsibility to fund research conducted by the OCRP to find new treatments and early detection for women with or at risk of ovarian cancer. This year, approximately 20,000 women will be diagnosed with ovarian cancer, and 15,000 women will die of this disease. Ovarian cancer has no test like the mammogram for breast cancer or the Pap test for cervical cancer. Because there is no reliable early detection test, women must rely on their and their doctor’s knowledge of ovarian cancer symptoms. However, most women and even their physicians do not know the symptoms of ovarian cancer, which are often confused with less- threatening conditions. Even with symptom awareness, by the time a woman has symptoms, she will already have late-stage cancer. Two out of three women with ovarian cancer are diagnosed when their cancer is late stage as mine was. 495 Current treatments are brutal and consist of long debulking surgeries, followed by months of chemotherapies. Even when the initial treatment response seems positive, around 70 to 95 percent of women diagnosed at stages III or IV will have a recurrence. The OCRP has one bold aim—to eliminate ovarian cancer. Since 1997, the OCRP has funded out-of-the-box, innovative research focused on detection, diagnosis, prevention, and control of ovarian cancer. Many of the funded proposals can be characterized as high risk and high reward. Although we take risk in the research we fund, we believe that investing in innovative research will result in a great breakthrough in the fight against ovarian cancer. I have volunteered my time for the past 3 years to serve as an integration panel member for the OCRP. I work alongside physicians, scientists, and other patient advocates, and together, we select proposals that we think merit funding. This spring, we received approximately 350 pre-applications. Sadly, we will only be able to fund approximately 30 full proposals. We worry that the cure could be heading into the trash can. The ovarian cancer community was extremely disappointed when we found out that the OCRP funding was reduced from $20 million in 2009 to $18.75 million in 2010. This cut is shocking when you consider our mortality rate has not decreased, and new treatments and an early detection test are still so desperately needed. By increasing the OCRP’s funding to $30 million for 2011 so that more research can be carried out, you not only help women currently battling this deadly beast, but future generations of women at risk. Thank you for this opportunity, and I am happy to answer any questions. Chairman INOUYE. I thank you very much for your testimony. This subcommittee, about 25 years ago, took a step that was considered rather courageous. We began the cancer research programs for breast cancer. And although women who wear the uniform are required to take physicals, and if they do have breast cancer, that should be somehow detected before they take the oath. We felt that since Defense Department had the money, we would begin our research programs. It may interest you to know that at this moment, DOD funds more research money than the National Institutes of Health. So I can assure you that your request is given our highest priority. Ms. MASON. Thank you. Senator COCHRAN. I was reminded, Mr. Chairman, that you and Senator Stevens led the way for this subcommittee in recommending these funding levels, and I am sure that we will continue to be guided by your good judgment and your serious request for continued funding. Chairman INOUYE. Thank you very much, Ms. Mason. [The statement follows:]

PREPARED STATEMENT OF KAREN MASON Good morning, Mr. Chairman, Ranking Member and Members of the Sub- committee. I am honored to appear before you in support of the Ovarian Cancer Na- tional Alliance’s request of a minimum of $30 million for the Department of Defense Ovarian Cancer Research Program in fiscal year 2011. My name is Karen Mason and I am an intensive care nurse from Pitman, New Jersey. I also serve as an Inte- 496 gration Panel member for the Ovarian Cancer Research Program, which I will refer to as the OCRP for the remainder of my testimony. As a 9 year survivor of late stage ovarian cancer, I feel a strong sense of responsibility to my community and sit before you today as the voice of all women with this disease, past, present and future. It is my hope that today I can beseech you to share this responsibility to fund research conducted by the OCRP that works to find new treatments and an early detection test for ovarian cancer. This year, approximately 20,000 women will be diagnosed with ovarian cancer and 15,000 women will die of this disease.1 Ovarian cancer has no test like the mammogram for breast cancer or pap test for cervical cancer. Because there is no reliable early detection test, women must rely on their—and their doctors’—knowledge of ovarian cancer symptoms. However, most women, and even their doctors, do not know the symptoms of ovarian cancer, which are bloating, pelvic or abdominal pain, urinary urgency or frequency, and difficulty eating or feeling full quickly. These symptoms are often confused with less threatening conditions. Unfortunately, even with symptom awareness, by the time a woman has symptoms, she will already have late stage cancer. Two out of three women with ovarian cancer are diagnosed when their cancer is late stage, as mine was.2 Current treatments are brutal and consist of long ‘‘debulking’’ surgeries followed by months of chemotherapies. Even when the initial treatment response seems positive, around 70–95 percent of women diagnosed at stages 3 or 4 will have a recurrence.3 During my 9 years of survivorship, I have befriended many women who also had late-stage ovarian cancer. One by one, I have watched most of these women die. Today in the Delaware Valley, I know of no other woman diagnosed at a late stage who has survived as long as I have. I still speak to woman newly diagnosed to offer them hope, but now I must hold a piece of my heart in reserve. The OCRP has one bold aim: to eliminate ovarian cancer. Since 1997, the OCRP has funded out of the box, innovative research focused on detection, diagnosis, prevention and control of ovarian cancer. Many of the funded proposals can be characterized as high risk and high reward. Although we take risks in the research we fund, we believe that investing in innovative research will result in great breakthroughs in the fight against ovarian cancer. An example of a scientific breakthrough that came out of the OCRP was the creation of the OVA1 test for risk stratification. This test was recently brought to the market and has received much media attention, most notably in the March 9 edition of the Wall Street Journal.4 In 2003, Dr. Zhen Zhang, an investigator at John Hop- kins School of Medicine received an Idea Development Award from the OCRP in the amount of $563,022. Dr. Zhang’s research eventually led to the creation of OVA1, which is a blood test that can help physicians determine if a woman’s pelvic mass is at risk for being malignant. While OVA1 is not an early detection test, it is a step in the right direction. The OCRP is also special in that it involves patient advocates at all levels. I have volunteered my time for the past 3 years to serve as an Integration Panel Member for the OCRP. I work alongside physicians, scientists and other patient advocates and together, we select proposals that we believe merit funding. Patient advocates hold equal weight with scientists and physicians when funding proposals and deciding the program’s vision for the future. Last fall during our vision setting day, I suggested that if the OCRP was truly seeking innovative out of the box researchers, perhaps the reviewers should be blinded as to who the researchers were and what institutions they represent. Imag- ine my delight when the panel agreed. Because researchers and institutions were blinded to us, a relatively unknown researcher from a lesser institution could con- ceivably be invited to submit a full proposal based solely on his or her idea. However, one of my community’s biggest fears is that the relatively low incidence of ovarian cancer (lifetime risk of developing invasive ovarian cancer is 1 in 71) versus other types of cancers (lifetime risk of developing breast cancer is 1 in 8) has

1 ‘‘Ovarian Cancer.’’ National Cancer Institute. May 4, 2010 . 2 M.J. Horner, L.A. G. Ries, M. Krapcho, N. Neyman, R. Aminou, N. Howlader, S.F. Altekruse, E.J. Feuer, L. Huang, A. Mariotto, B.A. Miller, D.R. Lewis, M.P. Eisner, D.G. Stinchcomb, E.K. Edwards, eds. SEER Cancer Statistics Review 1975–2006. National Cancer Institute, 2009. http://seer.cancer.gov/csr/1975l2006. 3 Armstrong, M.D., Deborah. ‘‘Treatment of Recurrent Disease Q&A.’’ John Hopkins Pathology. May 9, 2010 . 4 Johannes, Laura. ‘‘Test to Help Determine If Ovarian Masses Are Cancer.’’ The Wall Street Journal March 9, 2010. . 497 resulted in a much smaller investment in ovarian cancer research, thus dissuading young scientists from studying ovarian cancer and instead choosing to head into other organ sites for their careers in order to secure research funding.56 Additionally, Michael Seiden, M.D, Ph.D, President and CEO of Fox Chase Cancer Center and a fellow Integration Panel Member aptly stated that: ‘‘Reducing the burden of ovarian cancer requires recruiting and, more importantly, mentoring a group of scientists and clinicians who are committed to building sustained and productive careers in ovarian cancer research. Few academic medical or research centers have the large ovarian cancer research teams and the number of junior faculty focused on developing careers that are supported through peer-reviewed, competitively funded ovarian cancer research. Often junior faculty have few if any peers at their research center with common interests; thus, this group often lacks specific mentoring and networking opportunities that would maximize the pace of their career development.’’ The OCRP addressed this concern last year. We voted to award funding for the creation of an Ovarian Cancer Academy. The Academy puts the African proverb ‘‘it takes a village to raise a child’’ into action by training the next generation of ovarian cancer researchers. This award will develop a unique, interactive virtual academy that will provide intensive mentoring, national networking, and a peer group for junior faculty. Under the guidance of mentors and a chosen Academy Dean, it is hoped that successful, highly productive ovarian cancer researchers will emerge. But in order to continue supporting innovative research, the OCRP needs increased funding. This spring, we received approximately 350 pre-applications. In the end, we will only be able to fund approximately 30 full proposals. The ovarian cancer community worries that the cure could be heading to the trash can. Only with increased funding can the OCRP grow and continue to contribute to the fight against ovarian cancer.

OVARIAN CANCER COMMUNITY CONCERNED BY FUNDING CUTS TO THE OCRP The ovarian cancer community was extremely disappointed when we found out that OCRP funding was reduced from $20 million in 2009 to $18.75 in 2010. It is shocking when you consider our mortality rate has not decreased and new treatments and an early detection test are still so desperately needed.

The OCRP remains a modest program compared to the other cancer programs in the Congressionally-Directed Medical Research Programs, and yet has made vast strides in the fight against ovarian cancer with relatively few resources. With an increase in funding, the program can support more research into screening, early diagnosis and treatment of ovarian cancer.

5 ‘‘What Are the Key Statistics About Ovarian Cancer?’’ American Cancer Society. May 2, 2010 . 6 ‘‘Probability of Breast Cancer in American Women.’’ American Cancer Society. May 3, 2010 . 498

CONGRESSIONAL SUPPORT FOR FISCAL YEAR 2011 APPROPRIATION REQUEST This year, the ovarian cancer community has been proactive in securing support for our fiscal year 2011 appropriation request. A letter addressed to you in support of the $30 million appropriation for the OCRP was signed by Senator Robert Menen- dez and Senator Olympia Snowe, who were joined by Senators Daniel Akaka, Bar- bara Boxer, Sherrod Brown, Roland Burris, Ben Cardin, Bob Casey, Susan Collins, Chris Dodd, Richard Durbin, Kirsten Gillibrand, John Kerry, Kay Hagan, Ted Kauf- man, Herb Kohl, Frank Lautenberg, Joe Lieberman, Blanche Lincoln, Jack Reed, Bernard Sanders, Charles Schumer, Debbie Stabenow, Sheldon Whitehouse, and Ron Wyden. A companion letter in the House supporting the $30 million request was sent to Chairman Dicks and Ranking Member Young from Congresswoman Rosa DeLauro and Congressman Dan Burton, who were joined by 84 Representatives from both sides of the aisle: Representatives Andrews, Baldwin, Berkley, Berman, Blu- menauer, Boswell, Boucher, Corrine Brown, Capuano, Carney, Carson, Castor, Cleaver, Cohen, Conyers, Crowley, Cummings, Susan Davis, DeGette, Delahunt, Doggett, Donna Edwards, Ellison, Farr, Frank, Gerlach, Gene Green, Grijalva, Gutierrez, John Hall, Halvorson, Hastings, Hirono, Hodes, Holt, Eddie Bernice Johnson, Kildee, Kilroy, Kind, Peter King, Kucinich, Lance, Levin, LoBiondo, Loebsack, Lynch, Maloney, Edward Markey, Marshall, McDermott, McGovern, Meeks, Michaud, George Miller, Brad Miller, Dennis Moore, Gwen Moore, Chris- topher Murphy, Patrick Murphy, Nadler, Norton, Oberstar, Pascrell, Peterson, Rahall, Richardson, Rush, Schakowsky, Bobby Scott, David Scott, Sestak, Shea-Por- ter, Snyder, Mike Thompson, Tierney, Tonko, Tsongas, Van Hollen, Velazquez, Walz, Wasserman Schultz, Waxman, Wu and Yarmuth.

APPROPRIATION REQUEST FOR FISCAL YEAR 2011 On behalf of the entire ovarian cancer community—patients, family members, clinicians and researchers—we greatly appreciate your leadership and support of Fed- eral programs that seek to reduce and prevent suffering from ovarian cancer. Thank you in advance for your support of a minimum of $30 million in fiscal year 2011 funding for the Department of Defense Ovarian Cancer Research Program. Chairman INOUYE. Our next witness, Ms. Katie Savant, Deputy Director of Government Relations, National Military Family Asso- ciation. STATEMENT OF KATIE SAVANT, GOVERNMENT RELATIONS DEPUTY DIRECTOR, NATIONAL MILITARY FAMILY ASSOCIATION Ms. SAVANT. Chairman Inouye, Senator Cochran, the National Military Family Association would like to thank you for the opportunity to present testimony on the quality of life of military families. Many families have faced the challenge of deployment for 8 plus years. It is imperative that programs and services that provide a firm foundation for our families are fully funded. Programs must continue to adapt to the changing needs of service members and their families as they cope with multiple deployments, react to separations, balance reintegration, adjust to a wounded or ill service member, or grieve the loss of a fallen service member. Programs should provide for families in all stages of deployment and reach out to them in all geographical locations. Our association would like to thank the subcommittee for showing strong support for military families by funding essential programs that support today’s dynamic and diverse military family, but more needs to be done. In this statement, our association will address areas that require additional funding or new funding. In May 2008, our association commissioned the RAND Corpora- tion to conduct a longitudinal study on the deployment experiences of 1,500 families. The baseline findings were presented to Congress earlier this year. As a result of this research, our association be- 499 lieves we need dedicated resources, such as additional youth or teen centers, to support the needs of our older youth and teens during deployment. National Guard and Reserve component families appreciate the implementation of the Yellow Ribbon Program. Our association asked Congress to fully fund the Yellow Ribbon Program so it is consistent across the Nation and accessible to all families. The National Defense Authorization Act (NDAA) for Fiscal Year 2010 established the Office of Community Support for military families with special needs. The new office will go a long way in identifying and addressing special needs services. In order for this office to be successful, it will require funding. Military families place a high priority on the education of our military children. With States facing major budget cuts, Impact Aid will be a critical component to help school districts. We urge Con- gress to fully fund Impact Aid to its authorized levels. Military families are monitoring national healthcare reform and its potential impact in our population. We thank Congress for legislation that recognizes TRICARE meets minimal essential coverage under healthcare reform. However, we request your continued vigilance to ensure quality healthcare for military families. We suggest additional funding and flexibility in hiring practices when our military doctors deploy. We also recommend additional funding to DOD for possible civilian provider shortages due to reduced Medicare reimbursement rates and potential decreased provider availability due to healthcare reform. Our association applauds the recent passage of the Caregivers and Veterans Health Services Act. We would like to highlight two additional areas that will support our wounded service members. In last year’s NDAA, it provided compensation for service members with assistance in everyday living. Unfortunately, this DOD mandate was not funded. For a seamless transition from Active Duty to veteran status, the service member’s compensation amount should match the aid and attendance level the wounded service member would be eligible for by the Veterans Administration (VA). Additionally, current law permits the Secretary of the VA to provide a caregiver stipend. Caregivers have been shown to play an important role in maintaining the well-being of service members, and this provision should be funded. Our association has long advocated for enhanced benefits for survivors. Over 90 percent of families attended the ceremony at Dover to witness the dignified transfer of remains. Currently, the services are funding the travel out of pocket. We ask that funding be appropriated for travel costs for surviving family members to attend. Our association recognizes and appreciates the many resources and programs that support our military families during this time of war. The need will not go away when the war ends. We ask for you to help the Nation sustain and support our military families. Thank you. Chairman INOUYE. I thank you very much, Ms. Savant. We are well aware that in World War II and Korea and Vietnam, the words ‘‘military family’’ were not used too often because when 500 I was a little soldier, in my regiment, 4 percent had dependents, 96 percent were single. Ms. SAVANT. Wow. Chairman INOUYE. Today, in a typical regiment, 70 percent have dependents. So we know that this is an important part of army life and military life. So I can assure you that if we are to maintain this strong military posture, we will have to look into military families. Ms. SAVANT. Thank you. Senator COCHRAN. Mr. Chairman, thank you for your leadership in providing sensitive and meaningful assistance to families. And I know with programs like the Yellow Ribbon Program and others, families are doing a great job with self help and contributions that are very, very important to the morale of our troops, men and women. Ms. SAVANT. Thank you. Chairman INOUYE. Thank you very much. [The statement follows:]

PREPARED STATEMENT OF KATIE SAVANT The National Military Family Association is the leading nonprofit organization committed to improving the lives of military families. Our 40 years of accomplishments have made us a trusted resource for families and the Nation’s leaders. We have been at the vanguard of promoting an appropriate quality of life for active duty, National Guard, Reserve, retired service members, their families and survivors from the seven uniformed services: Army, Navy, Air Force, Marine Corps, Coast Guard, Public Health Service and the National Oceanic and Atmospheric Ad- ministration. Association Representatives in military communities worldwide provide a direct link between military families and the Association staff in the Nation’s capital. These volunteer Representatives are our ‘‘eyes and ears,’’ bringing shared local concerns to national attention. The Association does not have or receive Federal grants or contracts. Our website is: www.MilitaryFamily.org. Chairman Inouye, Ranking Member Cochran, and Distinguished Members of the Subcommittee, the National Military Family Association would like to thank you for the opportunity to present testimony on the quality of life of military families—the Nation’s families. As the war has continued, the quality of life of our service members and their families has been severely impacted. Your recognition of the sacrifices of these families and your response through legislation to the increased need for support have resulted in programs and policies that have helped sustain our families through these difficult times. In this statement, our Association will expand on several issues of importance to military families: Family Readiness, Family Health, and Family Transitions.

FAMILY READINESS The National Military Family Association believes policies and programs should provide a firm foundation for families buffeted by the uncertainties of deployment and transformation. It is imperative full funding for these programs be included in the regular budget process and not merely added on as part of supplemental funding. We promote programs that expand and grow to adapt to the changing needs of service members and families as they cope with multiple deployments and react to separations, reintegration, and the situation of those returning with both visible and invisible wounds. Standardization in delivery, accessibility, and funding are essential. Programs should provide for families in all stages of deployment and reach out to them in all geographic locations. Families should be given the tools to take greater responsibility for their own readiness. We appreciate provisions in the National Defense Authorization Acts and Appro- priations legislation in the past several years that recognized many of these important issues. Excellent programs exist across the Department of Defense (DOD) and the Services to support our military families. There are redundancies in some areas, times when a new program was initiated before looking to see if an existing pro- 501 gram could be adapted to answer an evolving need. Service members and their families are continuously in the deployment cycle, anticipating the next separation, in the throes of deployment, or trying to reintegrate when the service member returns. Dwell times seem shorter and shorter as training, schools, and relocation impede on time that is spent in the family setting. ‘‘My husband will have 3 months at home with us between deployment and being sent to school in January for 2 months and we will be PCSing soon afterwards....This does not leave much time for reintegration and reconnection.’’ We feel that now is the time to look at best practices and at those programs that are truly meeting the needs of families. In this section we will talk about existing programs, highlight best practices and identify needs. Child Care At every military family conference we attended last year, child care was in the top five issues affecting families—drop-in care being the most requested need. Some installations are responding to these needs in innovative ways. For instance, in a recent visit to Kodiak, Alaska, we noted the gym facility provided watch care for its patrons. Mom worked out on the treadmill or elliptical while her child played in a safe carpeted and fenced-in area right across from her. Another area of the gym, previously an aerobics room, had been transformed into a large play area for ‘‘Mom and me’’ groups to play in the frequently inclement weather. These solutions aren’t expensive, but do require thinking outside the box. Innovative strategies are needed to address the non-availability of after-hours child care (before 6 a.m. and after 6 p.m.) and respite care. We applaud the partnership between the Services and the National Association of Child Care Resource and Referral Agencies (NACCRRA) that provides subsidized child care to families who cannot access installation based child development centers. Families often find it difficult to obtain affordable, quality care especially during hard-to-fill hours and on weekends. Both the Navy and the Air Force have programs that provide 24/7 care. These innovative programs must be expanded to provide care to more families at the same high standard as the Services’ traditional child development programs. The Army, as part of the funding attached to its Army Family Covenant, has rolled out more space for respite care for families of deployed soldiers. Respite care is needed across the board for the families of the deployed and the wounded, ill, and injured. We are pleased the Services have rolled out more respite care for special needs families, but are concerned when we hear that some installations are already experiencing shortfalls of funding for respite care early in the year. At our Operation Purple® Healing Adventures camp for families of the wounded, ill, and injured, families told us there is a tremendous need for access to adequate child care on or near military treatment facilities. Families need the availability of child care in order to attend medical appointments, especially mental health appointments. Our Association encourages the creation of drop-in child care for medical appointments on the DOD or VA premises or partnerships with other organizations to provide this valuable service. We appreciate the requirement in the National Defense Authorization Act fiscal year 2010 (NDAA fiscal year 2010) calling for a report on financial assistance provided for child care costs across the Services and Components to support the families of those service members deployed in support of a contingency operation and we look forward to the results. Our Association urges Congress to ensure resources are available to meet the child care needs of military families to include hourly, drop-in and increased respite care across all Services for families of deployed service members and the wounded, ill, and injured, as well as those family members with special needs. Working with Youth Older children and teens must not be overlooked. School personnel need to be educated on issues affecting military students and must be sensitive to their needs. To achieve this goal, schools need tools. Parents need tools, too. Military parents constantly seek more resources to assist their children in coping with military life, especially the challenges and stress of frequent deployments. Parents tell us repeatedly they want resources to ‘‘help them help their children.’’ Support for parents in their efforts to help children of all ages is increasing, but continues to be frag- mented. New Federal, public-private initiatives, increased awareness, and support by DOD and civilian schools educating military children have been developed. How- ever, many military parents are either not aware such programs exist or find the programs do not always meet their needs. Our Association is working to meet this pressing need through our Operation Pur- ple® (OPC) summer camps. Unique in its ability to reach out and gather military 502 children of different age groups, Services, and components, our Operation Purple program provides a safe and fun environment in which military children feel immediately supported and understood. For the second year, with the support of private donors, we achieved our goal of sending 10,000 military children to camp in 2009. We also provided the camp experience to families of the wounded. This year, we expect to maintain those numbers by offering 92 weeks of camp in 40 states, Guam and Germany. In 2009, we introduced a new program under our Operation Purple umbrella, offering family reintegration retreats in the National Parks. They have been well received by our families and more apply than can attend. We are offering 10 retreats this year. Through our Operation Purple camps, our Association has begun to identify the cumulative effects multiple deployments are having on the emotional growth and well being of military children and the challenges posed to the relationship between deployed parent, caregiver, and children in this stressful environment. Under- standing a need for qualitative analysis of this information, we commissioned the RAND Corporation to conduct a pilot study in 2007 aimed at the current functioning and wellness of military children attending Operation Purple camps and assessing the potential benefits of the OPC program in this environment of multiple and extended deployments. In May 2008, we embarked on phase two of the project—a longitudinal study on the experience of 1,507 families, which is a much larger and more diverse sample than included in our pilot study. RAND followed these families for 1 year, and inter- viewed the non-deployed caregiver/parent and one child per family between 11 and 17 years of age at three time points over a year. Recruitment of participants was extremely successful because families were eager to share their experiences. The research addressed two key questions: How are school-age military children faring? What types of issues do military children face related to deployment? In December, the baseline findings of the research were published in the journal Pediatrics. Findings showed: —As the months of parental deployment increased so did the child’s challenges. —The total number of months away mattered more than the number of deployments. —Older children experienced more difficulties during deployment. —There is a direct correlation between the mental health of the caregiver and the well-being of the child. —Girls experienced more difficulty during reintegration, the period of months re- adjusting after the service member’s homecoming. —About one-third of the children reported symptoms of anxiety, which is somewhat higher than the percentage reported in other national studies of children. —In these initial findings, there were no differences in results between Services or Components. What are the implications? Families facing longer deployments need targeted support—especially for older teens and girls. Supports need to be in place across the entire deployment cycle, including reintegration, and some non-deployed parents may need targeted mental health support. One way to address these needs would be to create a safe, supportive environment for older youth and teens. Dedicated Youth Centers with activities for our older youth would go a long way to help with this. Our Association feels that more dedicated resources, such as youth or teen centers, would be beneficial to address the needs of our older youth and teens during deployment. Families Overseas Families stationed overseas face increased challenges when their service member is deployed into theater. One such challenge we have heard from families stationed in European Command (EUCOM) concerns care for a family member, usually the spouse, who may be injured or confined to bed for an extended illness during deployment. Instead of pulling the service member back from theater, why not provide transportation for an extended family member or friend to come from the States to care for the injured or ill family member? This has been a recommendation from the EUCOM Quality of Life conference for several years. National Guard and Reserve The National Military Family Association has long recognized the unique challenges our Reserve Component families face and their need for additional support. National Guard and Reserve families are often geographically dispersed, live in rural areas, and do not have the same family support programs as their active duty 503 counterparts. The final report from the Commission on the National Guard and Re- serve confirmed what we have always asserted: ‘‘Reserve Component families face special challenges because they are often at a considerable distance from military facilities and lack the on-base infrastructure and assistance available to active duty families.’’ This is especially true when it comes to accessing the same level of counseling and behavioral health support as active duty families. However, our Association applauds the innovative counseling and behavioral health support to National Guard and Reserve families, in the form of Military OneSource counseling, the TRICARE Assistance Program (TRIAP), and Military Family Life Consultants (MFLC). Com- bined, these valuable resources are helping to address a critical need for our Re- serve Component families. In the past several years, great strides have been made by both Congress and the Services to help strengthen our National Guard and Reserve families. Our Associa- tion wishes to thank Congress for authorizing these important provisions. We urge you to fully fund these vital quality of life programs critical to our Reserve Compo- nent families, who have sacrificed greatly in support of our Nation. In addition, our Association would like to thank Congress for the provisions allowing for the implementation of the Yellow Ribbon Program, and for including reporting requirements on the program’s progress in the NDAA fiscal year 2010. We continue to urge Congress to make the funding for this program permanent. In addition, we ask that you conduct oversight hearings to ensure that Yellow Ribbon services are consistent across the nation. We also ask that the definition of family member be expanded to allow non-ID card holders to attend these important programs, in order to support their service member and gain valuable information. Our Association asks Congress to fully fund the Yellow Ribbon Program, and provide oversight hearings to ensure that Yellow Ribbon services are consistent across the nation, and are accessible to all Reserve Component families. We also ask for funding for those persons designated by the service member to attend Yellow Ribbon Program events.

FAMILY HEALTH Family readiness calls for access to quality healthcare and mental health services. Families need to know the various elements of their military health system are coordinated and working as a synergistic system. Our Association is concerned the DOD military healthcare system may not have all the resources it needs to meet both the military medical readiness mission and provide access to healthcare for all beneficiaries. It must be funded sufficiently, so the direct care system of military treatment facilities (MTF) and the purchased care segment of civilian providers can work in tandem to meet the responsibilities given under the TRICARE contracts, meet readiness needs, and ensure access for all military beneficiaries. Congress must provide timely and accurate funding for healthcare. DOD healthcare facilities must be funded to be ‘‘world class,’’ offering state-of-the-art healthcare services supported by evidence-based research and design. Funding must also support the renovation of existing facilities or complete replacement of out-of- date DOD healthcare facilities. As we get closer to the closure of Walter Reed Army Medical Center and the opening of the new Fort Belvoir Community Hospital and the new Walter Reed National Military Medical Center, as part of the National Cap- itol Region BRAC process, we must be assured these projects are properly and fully funded. We encourage Congress to provide any additional funding recommended by the Defense Health Board’s BRAC Subcommittee’s report. Military Health System Improving Access to Care In the question and answer period during the U.S. Senate Committee on Armed Services’ Subcommittee on Personnel on June 3, 2009, Senator Lindsey Graham (R- SC) asked panel members to ‘‘give a grade to TRICARE.’’ Panel members rated TRICARE a ‘‘B’’ or a ‘‘C minus.’’ Our Association’s Director of Government Relations stated it was a two part question and assigned the ‘‘quality of care, B. Access to care, C minus.’’ The panelist and Subcommittee Members discussion focused on access issues in the direct care system—our military hospitals and clinics—reinforcing what our Association has observed for years. We have consistently heard from families that their greatest healthcare challenge has been getting timely care from their local military hospital or clinic. Our Association continues to examine military families’ experiences with accessing the Military Health System (MHS). Families’ main issues are: access to their Primary Care Managers (PCM); getting someone to answer the phone at central ap- 504 pointments; having appointments available when they finally got through to central appointments; after hours care; getting a referral for specialty care; being able to see the same provider or PCM; and having appointments available 60, 90, and 120 days out in our MTFs. Families familiar with how the MHS referral system works seem better able to navigate the system. Those families who are unfamiliar report delays in receiving treatment or sometimes decide to give up on the referral process and never obtain a specialty appointment. Continuity of care is important to maintain quality of care. The MTFs are stressed from 9 years of provider deployments, directly affecting the quality of care and contributing to increased costs. Our Asso- ciation thanks Congress for requiring, in the NDAA fiscal year 2009, a report on access to care and we look forward to the findings. This report must distinguish between access issues in the MTFs, as opposed to access in the civilian TRICARE networks. Our most seriously wounded, ill, and injured service members, veterans, and their families are assigned case managers. In fact, there are many different case managers: Federal Recovery Coordinators (FRC), Recovery Care Coordinators, coordinators from Service branch, Traumatic Brain Injury (TBI) care coordinators, Depart- ment of Veteran Affairs (VA) liaisons, et cetera. The goal is for a seamless transition of care between and within the two governmental agencies, DOD and the VA. How- ever, with so many coordinators to choose from, families often wonder which one is the ‘‘right’’ case manager. We often hear from families, some whose service member has long been medically retired with a 100 percent disability rating or others with less than 1 year from date-of-injury, who have not yet been assigned a FRC. We need to look at whether the multiple, layered case managers have streamlined the process, or have only aggravated it. Our Association still finds families trying to navigate alone a variety of complex healthcare systems, trying to find the right combination of care. Individual Service wounded, ill, and injured program directors and case managers are often reluctant to inform families that FRCs exist or that the family qualifies for one. Many qualify for and use Medicare, VA, DOD’s TRICARE direct and purchased care, private health insurance, and state agencies. Why can’t the process be streamlined? Support for Special Needs Families Case management for military beneficiaries with special needs is not consistent because the coordination of the military family’s care is being done by a non-synergistic MHS. Beneficiaries try to obtain an appointment and then find themselves getting partial healthcare within the MTF, while other healthcare is referred out into the purchased care network. Thus, military families end up managing their own care. Incongruence in the case management process becomes more apparent when military family members transfer from one TRICARE region to another and is further exacerbated when a special needs family member is involved. Families need a seamless transition and a warm handoff between TRICARE regions and a universal case management process across the MHS. The current case management system is under review by DOD and TRICARE Management Activity (TMA). Each TRICARE Managed Care Contractor has created different case management processes. We applaud Congress and DOD’s desire to create robust healthcare, educational, and family support services for special needs children. But, these robust services do not follow them when they retire. We encourage the Services to allow these military families the opportunity to have their final duty station be in an area of their choice. We suggest the Extended Care Health Option (ECHO) be extended for 1 year after retirement for those already enrolled in ECHO prior to retirement. If the ECHO program is extended, it must be for all who are eligible for the program. We should not create a different benefit simply based on diagnosis. There has been discussion over the past years by Congress and military families regarding the ECHO program. The NDAA fiscal year 2009 included a provision to increase the cap on certain benefits under the ECHO program and the NDAA fiscal year 2010 established the Office of Community Support for Military Families with Special Needs. The ECHO program was originally designed to allow military families with special needs to receive additional services to offset their lack of eligibility for state or Federally provided services impacted by frequent moves. We suggest that before making any more adjustments to the ECHO program, Congress should direct DOD to certify if the ECHO program is working as it was originally designed and if it has been effective in addressing the needs of this population. We need to make the right fixes so we can be assured we apply the correct solutions. This new office will go a long way in identifying and addressing special needs. However, we must remember that our special needs families often require medical, educational, 505 and family support resources. This new office must address all these various needs in order to effectively implement change. We ask for funding for the Office of Community Support for Military Families with Special Needs so this important new office can begin helping our special needs families. National Guard and Reserve Member Family Health Care National Guard and Reserve families need increased education about their healthcare benefits. We also believe that paying a stipend (NDAA fiscal year 2008) to a mobilized National Guard or Reserve member for their family’s coverage under their employer-sponsored insurance plan may prove to be more cost-effective for the government than subsidizing 72 percent of the costs of TRICARE Reserve Select for National Guard or Reserve members not on active duty. Grey Area Reservist Our Association would like to thank Congress for the new TRICARE benefit for Grey Area Reservists. We want to make sure this benefit is quickly implemented and they have access to a robust network. TRICARE Reimbursement Our Association is concerned that continuing pressure to lower Medicare reimbursement rates will create a hollow benefit for TRICARE beneficiaries. As the 111th Congress takes up Medicare legislation, we request consideration of how this legislation will impact military families’ healthcare, especially access to mental health services. National provider shortages in the psychological health field, especially in child and adolescent psychology, are exacerbated in many cases by low TRICARE reimbursement rates, TRICARE rules, or military-unique geographic challenges—for example large populations in rural or traditionally underserved areas. Many psychological health providers are willing to see military beneficiaries on a voluntary status. However, these providers often tell us they will not participate in TRICARE because of what they believe are time-consuming requirements and low reimbursement rates. More must be done to persuade these providers to participate in TRICARE and become a resource for the entire system, even if that means DOD must raise reimbursement rates. If that is the case, DOD may need additional funding for the flexibility to increase provider reimbursement rates if shortages develop. Pharmacy We caution DOD about generalizing findings of certain beneficiary pharmacy behaviors and automatically applying them to our Nation’s unique military population. We encourage Congress to require DOD to utilize peer-reviewed research involving beneficiaries and prescription drug benefit options, along with performing additional research involving military beneficiaries, before making any recommendations on prescription drug benefit changes, such as co-payment and tier structure changes for military service members, retirees, their families, and survivors. We appreciate the inclusion of Federal pricing for the TRICARE retail pharmacies in the NDAA fiscal year 2008. However, we still need to examine its effect on the cost of medications for both beneficiaries and DOD. Also, we will need to see how this potentially impacts Medicare, civilian private insurance, and the National Health Care Reform drug pricing negotiations. We believe it is imperative that all medications available through TRICARE Re- tail Pharmacy (TRRx) should also be made available through TRICARE Mail Order Pharmacy (TMOP). Medications treating chronic conditions, such as asthma, diabetes, and hypertension should be made available at the lowest level of co-payment regardless of brand or generic status. We agree with the recommendations of The Task Force on the Future of Military Health Care that over-the-counter (OTC) drugs be a covered pharmacy benefit without a co-payment for TMOP Tier 1 medications. The new T3 TRICARE contract will provide TRICARE Managed Care Contractors and Express-Scripts, Inc. the ability to link pharmacy data with disease management. This will allow for better case management, increased compliance, and decreased cost, especially for our chronically ill beneficiaries. However, this valuable tool is currently unavailable because the T3 contract is partially under protest and has not yet been awarded. National Health Care We thank Congress for legislation that recognizes that TRICARE meets minimal essential coverage under National Health Care reform. However, we request your continued vigilance to ensure quality healthcare for military families. The perfect storm is brewing. TMA will institute the new T3 contact at the same time 506 healthcare reform changes are implemented. Currently, at least one out of three TRICARE Managed Care Contractors could change. This means that the contracts of those TRICARE providers would need to be renegotiated. Healthcare reform and Medicare reimbursement rate changes are adding to the demands and uncertainty of our providers. Our Association is concerned that providers will be unwilling to remain in the TRICARE network and it will become very difficult to recruit new providers. The unintended consequence may be a decrease in access of care due the lack of available healthcare providers. DOD will need additional funding to increase reimbursement rates if provider shortages develop. DOD Must Look for Savings We ask Congress to establish better oversight for DOD’s accountability in becoming more cost-efficient. We recommend: —Requiring the Comptroller General to audit MTFs on a random basis until all have been examined for their ability to provide quality healthcare in a cost-effective manner; —Creating an oversight committee, similar in nature to the Medicare Payment Advisory Commission, which provides oversight to the Medicare program and makes annual recommendations to Congress. The Task Force on the Future of Military Health Care often stated it was unable to address certain issues not within their charter or the timeframe in which they were commissioned to examine the issues. This Commission would have the time to examine every issue in an unbiased manner. —Establishing a Unified ‘‘Joint’’ Medical Command structure, which was recommended by the Defense Health Board in 2006. Our Association believes optimizing the capabilities of the facilities of the direct care system through timely replacement of facilities, increased funding allocations, and innovative staffing would allow more beneficiaries to be cared for in the MTFs, which DOD asserts is the most cost effective. The Task Force made recommendations to make the DOD MHS more cost-efficient which we support. They conclude the MHS must be appropriately sized, resourced, and stabilized; and make changes in its business and healthcare practices. We suggest additional funding and flexibility in hiring practices to address MTF provider deployments. We recommend additional funding to DOD for potential civilian provider shortages within the community due to reduced Medicare reimbursement rates and potential decreased provider availability due to healthcare reform. Our Association recommends a 1 year transitional active duty ECHO benefit for all eligible family members of service members who retire. We believe that Reserve Component families should be given the choice of a stipend to continue their employer provided care during deployment. Behavioral Health Care Our Nation must help returning service members and their families cope with the aftermath of war. DOD, VA, and State agencies must partner in order to address behavioral health issues early in the process and provide transitional mental health programs. Partnering will also capture the National Guard and Reserve member population, who often straddle these agencies’ healthcare systems. Full Spectrum of Care As the war continues, families’ need for a full spectrum of behavioral health services—from preventative care to stress reduction techniques, individual or family counseling, to medical mental health services—continues to grow. The military offers a variety of psychological health services, both preventative and treatment, across many agencies and programs. However, as service members and families experience numerous lengthy and dangerous deployments, we believe the need for confidential, preventative psychological health services will continue to rise. It will remain high, even after military operations scale down. Our study found the mental health of the caregiver directly affects the overall well-being of the children. There- fore, we need to treat the family as a unit rather than as individuals because the caregiver’s health determines the quality of life for the children. Access to Behavioral Health Care Our Association is concerned about the overall shortage of psychological health providers in TRICARE’s direct and purchased care network. DOD’s Task Force on Mental Health stated timely access to the proper psychological health provider remains one of the greatest barriers to quality mental health services for service members and their families. The Army Family Action Plan (AFAP) identified mental health issues as their number three issue for 2010. While families are pleased more 507 psychological health providers are available in theater to assist their service members, they are disappointed with the resulting limited access to providers at home. Families are reporting increased difficulty in obtaining appointments with social workers, psychologists, and psychiatrists at their MTFs and clinics. The military fuels the shortage by deploying some of its child and adolescent psychology providers to combat zones. Providers remaining at home report they are overwhelmed by treating active duty members and are unable to fit family members into their schedules. This can lead to compassion fatigue, creating burnout and exacerbating the provider shortage problem. We have seen an increase in the number of psychological health providers joining the purchased care side of the TRICARE network. However, the access standard is 7 days. We hear from military families after accessing the psychological health provider list on the contractor’s websites that the provider is full and no longer taking patients. The list must be up-to-date in order to handle real time demands by families. We need to continue to recruit more psychological health providers to join the TRICARE network and we need to make sure we specifically add those in specialty behavioral healthcare areas, such as child and adolescence psychology and psychiatrists. Families must be included in mental health counseling and treatment programs for service members. Family members are a key component to a service member’s psychological well-being. We recommend an extended outreach program to service members, veterans, and their families of available psychological health resources, such as DOD, VA, and State agencies. Frequent and lengthy deployments create a sharp need in psychological health services by family members and service members as they get ready to deploy and after their return. There is also an increase in demand in the wake of natural disasters, such as hurricanes and fires. We need to maintain a flexible pool of psychological health providers who can increase or decrease rapidly in numbers depending on demand by the MHS. Currently, Military Family Life Consultants and Military OneSource counseling are providing this type of service for military families on the family support side. The recently introduced web-based TRICARE Assistance Pro- gram (TRIAP) offers another vehicle for non-medical counseling, especially for those who live far from counselors. We need to make the Services, along with military family members, more aware of resources along the continuum. We need the flexibility of support in both the MHS and family support arenas. We must educate civilian network providers about our military culture. Communities along with non- government organizations (NGO) are beginning to fulfill this role, but more needs to be done. Availability of Treatment Do DOD, VA and State agencies have adequate psychological health providers, programs, outreach, and funding? Better yet, where will the veteran’s spouse and children go for help? Many will be left alone to care for their loved one’s invisible wounds resulting from frequent and long combat deployments. Who will care for them when they are no longer part of the DOD healthcare system? The Army’s Mental Health Advisory Team (MHAT) IV report links reducing family issues to reducing stress on deployed service members. The team found the top non-combat stressors were deployment length and family separation. They noted soldiers serving a repeat deployment reported higher acute stress than those on their first deployment and the level of combat was the major contribution for their psychological health status upon return. Our study, along with other research, on the impact of deployment on caregivers and children found it was the cumulative time deployed that caused increased stress. These reports demonstrate the amount of stress being placed on our troops and their families. Our Association is especially concerned with the scarcity of services available to the families as they leave the military following the end of their activation or enlistment. Due to the service member’s separation, the families find themselves ineligible for TRICARE, Military OneSource, and are very rarely eligible for healthcare through the VA. Many will choose to locate in rural areas lacking available psychological health providers. We need to address the distance issues families face in finding psychological health resources and obtaining appropriate care. Isolated service members, veterans, and their families do not have the benefit of the safety net of services and programs provided by MTFs, VA facilities, Community-Based Out- patient Centers and Vet Centers. We recommend: —using and funding alternative treatment methods, such as telemental health; —modifying licensing requirements in order to remove geographic practice barriers that prevent psychological health providers from participating in telemental health services outside of a VA facility; 508

—educating civilian network psychological health providers about our military culture as the VA incorporates Project Hero; and —encouraging DOD and VA to work together to provide a seamless ‘‘warm handoff’’ for families, as well as service members transitioning from active duty to veteran status and funding additional transitional support programs if necessary. National Guard and Reserve Members The National Military Family Association is especially concerned about fewer mental healthcare services available for the families of returning National Guard and Reserve members as well as service members who leave the military following the end of their enlistment. They are eligible for TRICARE Reserve Select, but as we know, National Guard and Reserve members are often located in rural areas where there may be no mental health providers available. Policy makers need to address the distance issues that families face in linking with military mental health resources and obtaining appropriate care. Isolated National Guard and Reserve families do not have the benefit of the safety net of services provided by MTFs and installation family support programs. Families want to be able to access care with a provider who understands or is sympathetic to the issues they face. We recommend the use of alternative treatment methods, such as telemental health; increasing mental health reimbursement rates for rural areas; modifying licensing requirements in order to remove geographic practice barriers that prevent mental health providers from participating in telemental health services; and educating civilian network mental health providers about our military culture. We hear the National Guard Bureau’s Psychological Health Services (PHS) is not working as designed to address their mental health issues. This program needs to be re-evaluated to determine its effectiveness. Children Our Association is concerned about the impact deployment and/or the injury of the service member is having on our most vulnerable population, children of our military and veterans. Our study on the impact of the war on caregivers and children found deployments are creating layers of stressors, which families are experiencing at different stages. Teens especially carry a burden of care they are reluctant to share with the non-deployed parent in order to not ‘‘rock the boat.’’ They are often encumbered by the feeling of trying to keep the family going, along with anger over changes in their schedules, increased responsibility, and fear for their deployed parent. Children of the National Guard and Reserve members face unique challenges since there are no military installations for them to utilize. They find themselves ‘‘suddenly military’’ without resources to support them. School systems are generally unaware of this change in focus within these family units and are ill prepared to lookout for potential problems caused by these deployments or when an injury occurs. Also vulnerable, are children who have disabilities that are further complicated by deployment and subsequent injury of the service members. Their families find stress can be overwhelming, but are afraid to reach out for assistance for fear of retribution to the service member’s career. They often choose not to seek care for themselves or their families. We appreciate the inclusion of a study on the mental health needs of our children in the NDAA fiscal year 2010 and hope the research we commissioned will provide useful information as the study is designed. The impact of the wounded, ill, and injured on children is often overlooked and underestimated. Military children experience a metaphorical death of the parent they once knew and must make many adjustments as their parent recovers. Many families relocate to be near the treating MTF or the VA Polytrauma Center in order to make the rehabilitation process more successful. As the spouse focuses on the rehabilitation and recovery, older children take on new roles. They may become the caregivers for other siblings, as well as for the wounded parent. Many spouses send their children to stay with neighbors or extended family members, as they tend to their wounded, ill, and injured spouse. Children get shuffled from place to place until they can be reunited with their parents. Once reunited, they must adapt to the parent’s new injury and living with the ‘‘new normal.’’ We appreciate the inclusion of a study to assess the impact on children of the severely wounded in the NDAA fiscal year 2010. We encourage partnerships between government agencies, DOD, VA and State agencies and recommend they reach out to those private and NGOs who are experts on children and adolescents. They could identify and incorporate best practices in the prevention and treatment of mental health issues affecting our military children. We must remember to focus on preventative care upstream, while still in the active duty phase, in order to have a solid family unit as they head into the veteran 509 phase of their lives. School systems must become more involved in establishing and providing supportive services for our nation’s children. Caregiver Burnout In the ninth year of war, care for the caregivers must become a priority. There are several levels of caregivers. Our Association hears from the senior officer and enlisted spouses who are so often called upon to be the strength for others. We hear from the healthcare providers, educators, chaplains, and counselors who are working long hours to assist service members and their families. They tell us they are overburdened, burnt out, and need time to recharge so they can continue to serve these families. These caregivers must be afforded respite care, given emotional support through their command structure, and be provided effective family programs. Education The DOD, VA, and State agencies must educate their healthcare and mental health professionals of the effects of mild Traumatic Brain Injury (mTBI) in order to help accurately diagnose and treat the service member’s condition. They must be able to deal with polytrauma—Post-Traumatic Stress Disorder (PTSD) in combination with multiple physical injuries. We need more education for civilian healthcare providers on how to identify signs and symptoms of mild TBI and PTSD. The families of service members and veterans must be educated about the effects of mTBI and PTSD in order to help accurately diagnose and treat the service member/veteran’s condition. These families are on the ‘‘sharp end of the spear’’ and are more likely to pick up on changes attributed to either condition and relay this information to their healthcare providers. Programs are being developed by each Service. However, they are narrow in focus targeting line leaders and healthcare providers, but not broad enough to capture our military family members and the communities they live in. Reintegration Programs Reintegration programs become a key ingredient in the family’s success. Our As- sociation believes we need to focus on treating the whole family with programs offering readjustment information; education on identifying mental health, substance abuse, suicide, and TBI; and encouraging them to seek assistance when having financial, relationship, legal, and occupational difficulties. We appreciate the inclusion in the NDAA fiscal year 2010 for education programs targeting pain management and substance abuse for our families. As Services roll out suicide prevention programs, we need to include our families, communities, and support personnel. Successful return and reunion programs will require attention and funding over the long term, as well as a strong partnership at all levels between the various mental health arms of DOD, VA, and State agencies. DOD and VA need to provide family and individual counseling to address these unique issues. Opportunities for the entire family and for the couple to reconnect and bond must also be provided. Our Association has recognized this need and successfully piloted family retreats in the National Parks promoting family reintegration following deployment. We recommend an extended outreach program to service members, veterans, and their families of available psychological health resources, such as DOD, VA, and State agencies. We encourage Congress to request DOD to include families in its Psychological Health Support survey; perform a pre and post-deployment mental health screening on family members (similar to the PDHA and PDHRA currently being done for service members). We recommend the use and funding of alternative treatment methods, such as telemental health; increasing mental health reimbursement rates for rural areas; modifying licensing requirements in order to remove geographic practice barriers that prevent mental health providers from participating in telemental health services; and educating civilian network mental health providers about our military culture. Caregivers must be afforded respite care; given emotional support through their command structure; and be provided effective family programs. Wounded Service Members Have Wounded Families Our Association asserts that behind every wounded service member and veteran is a wounded family. It is our belief the government, especially the DOD and VA, must take a more inclusive view of military and veterans’ families. Those who have the responsibility to care for the wounded, ill, and injured service member must also consider the needs of the spouse, children, parents of single service members and their siblings, and the caregivers. DOD and VA need to think proactively as a team 510 and one system, rather than separately; and addressing problems and implementing initiatives upstream while the service member is still on active duty status. Reintegration programs become a key ingredient in the family’s success. For the past 2 years, we have piloted our Operation Purple® Healing Adventures camp to help wounded service members and their families learn to play again as a family. We hear from the families who participate in this camp, as well as others dealing with the recovery of their wounded service members that, even with Congressional intervention and implementation of the Services’ programs, many issues still create difficulties for them well into the recovery period. Families find themselves having to redefine their roles following the injury of the service member. They must learn how to parent and become a spouse/lover with an injury. Each member needs to understand the unique aspects the injury brings to the family unit. Parenting from a wheelchair brings a whole new challenge, especially when dealing with teenagers. Parents need opportunities to get together with other parents who are in similar situations and share their experiences and successful coping methods. Our Associa- tion believes we need to focus on treating the whole family with DOD and VA programs offering skill based training for coping, intervention, resiliency, and overcoming adversities. Injury interrupts the normal cycle of deployment and the reintegration process. We must provide opportunities for the entire family and for the couple to reconnect and bond, especially during the rehabilitation and recovery phases. Brooke Army Medical Center (BAMC) has recognized a need to support these families by expanding in terms of guesthouses co-located within the hospital grounds and a family reintegration program for their Warrior Transition Unit. The on-base school system is also sensitive to issues surrounding these children. A warm, welcoming family support center located in guest housing serves as a sanctuary for family members. The DOD and VA could benefit from looking at successful programs like BAMC’s which has found a way to embrace the family unit during this difficult time. The Vet Centers are an available resource for veterans’ families providing adjustment, vocational, and family and marriage counseling. The VA healthcare facilities and the community-based outpatient clinics (CBOCs) have a ready supply of mental health providers. We recommend DOD partner with the VA to allow military families access to mental health services. We also believe Congress should require the VA, through its Vet Centers and healthcare facilities to develop a holistic approach to care by including families when providing mental health counseling and programs to the wounded, ill, and injured service member or veteran. The Defense Health Board has recommended DOD include military families in its mental health studies. We agree. We encourage Congress to direct DOD to include families in its Psychological Health Support survey and perform a pre and post-deployment mental health screening on family members (similar to the PDHA and PDHRA currently being done for service members). This recommendation will require additional funding. We appreciate the NDAA fiscal year 2010 report on the impact of the war on families and the DOD’s Millennium Cohort Study including families. Both will help us gain a better understanding of the long-term effects of war on our military families. Transitioning for the Wounded and Their Families Transitions can be especially problematic for wounded, ill, and injured service members, veterans, and their families. The DOD and the VA healthcare systems, along with State agency involvement, should alleviate, not heighten these concerns. They should provide for coordination of care, starting when the family is notified that the service member has been wounded and ending with the DOD, VA, and State agencies working together, creating a seamless transition, as the wounded service member transfers between the two agencies’ healthcare systems and, eventually, from active duty status to veteran status. Transition of healthcare coverage for our wounded, ill, and injured and their family members is a concern of our Association. These service members and families desperately need a healthcare bridge as they deal with the after effects of the injury and possible reduction in their family income. We have created two proposals. Serv- ice members who are medically retired and their families should be treated as active duty for TRICARE fee and eligibility purposes for 3 years following medical retirement. This proposal will allow the family not to pay premiums and be eligible for certain programs offered to active duty, such as ECHO for 3 years. Following that period, they would pay TRICARE premiums at the rate for retirees. Service members medically discharged from service and their family members should be allowed to continue for 1 year as active duty for TRICARE and then start the Continued Health Care Benefit Program (CHCBP) if needed. 511

Caregivers Caregivers need to be recognized for the important role they play in the care of their loved one. Without them, the quality of life of the wounded service members and veterans, such as physical, psycho-social, and mental health, would be significantly compromised. They are viewed as an invaluable resource to DOD and VA healthcare providers because they tend to the needs of the service members and the veterans on a regular basis. And, their daily involvement saves DOD, VA, and State agency healthcare dollars in the long run. Their long-term psychological care needs must be addressed. Caregivers of the severely wounded, ill, and injured service members who are now veterans have a long road ahead of them. In order to perform their job well, they will require access to mental health services and these services must be funded. The VA has made a strong effort in supporting veterans’ caregivers. The DOD should follow suit and expand their definition. We appreciate the inclusion in NDAA fiscal year 2010 of compensation for service members with assistance in everyday living. This provision will need funding. Compensation of caregivers should be a priority for DOD and the Secretary of Homeland Security for our Coast Guard. Caregivers must be recognized for their sacrifices and the important role they play in maintaining the quality of life of our wounded, ill, and injured service members and veterans. Current law allows the Secretary of the VA to provide a caregiver stipend, however it is an unfunded mandate. Our Association strongly believes this stipend needs to be fully funded. Consideration should also be given to creating innovative ways to meet the healthcare and insurance needs of the caregiver, with an option to include their family. Current law does not include a ‘‘family’’ option. There must be a provision for transition benefits for the caregiver if the caregiver’s services are no longer needed, chooses to no longer participate, or is asked by the veteran to no longer provide services. The caregiver, once qualified, should still be able to maintain healthcare coverage for 1 year. Compensation would dis- continue following the end of services/care provided by the caregiver. Our Associa- tion looks forward to discussing details of implementing such a plan with Members of this Subcommittee. The VA currently has eight caregiver assistance pilot programs to expand and improve healthcare education and provide needed training and resources for caregivers who assist disabled and aging veterans in their homes. Caregivers’ responsibilities start while the service member is still on active duty. DOD should evaluate these pilot programs to determine whether to adopt them for themselves. If adopted, DOD will need funding for these programs. Relocation Allowance and Housing Active Duty service members and their spouses qualify through the DOD for military orders to move their household goods when they leave the military service. Medically retired service members are given a final PCS move. Medically retired married service members are allowed to move their family, however, medically retired single service members only qualify for moving their own personal goods. Our Association suggests that legislation be passed to allow medically retired single service members the opportunity to have their caregiver’s household goods moved as a part of the medical retired single service member’s PCS move. This should be allowed for the qualified caregiver of the wounded, ill, and injured service member and the caregiver’s family (if warranted), such as a sibling who is married with children or mom and dad. This would allow for the entire caregiver’s family to move, not just the caregiver. The reason for the move is to allow the medically retired single service member the opportunity to relocate with their caregiver to an area offering the best medical care, rather than the current option that only allows for the medically retired single service member to move their belongings to where the caregiver currently resides. The current option may not be ideal because the area in which the caregiver lives may not be able to provide all the healthcare services required for treating and caring for the medically retired service member. In- stead of trying to create the services in the area, a better solution may be to allow the medically retired service member, their caregiver, and the caregiver’s family to relocate to an area where services already exist. The decision on where to relocate for optimum care should be made with the Fed- eral Recovery Coordinator (case manager), the service member’s medical physician, the service member, and the caregiver. All aspects of care for the medically retired service member and their caregiver shall be considered. These include a holistic examination of the medically retired service member, the caregiver, and the caregiver’s family for, but not limited to, their needs and opportunities for healthcare, employment, transportation, and education. The priority for the relocation should be 512 where the best quality of services is readily available for the medically retired service member and his/her caregiver. This relocation provision will require DOD funding. The consideration for a temporary partial shipment of caregiver’s household goods may also be allowed, if deemed necessary by the case management team. Provide transitioning wounded, ill, and injured service members and their families a bridge of extended active duty TRICARE eligibility for 3 years, comparable to the benefit for surviving spouses. Service members medically discharged from service and their family members shall be allowed to continue for 1 year as active duty for TRICARE and then start the Continued Health Care Benefit Program (CHCBP) if needed. Caregivers of the wounded, ill and injured must be provided with opportunities for training, compensation and other support programs because of the important role they play in the successful rehabilitation and care of the service member. The National Military Family Association is requesting the ability for medically retired single service members to be allowed the opportunity to have their caregiver’s household goods moved as a part of the medically retired single service member’s PCS move. Senior Oversight Committee Our Association is appreciative of the provision in the NDAA fiscal year 2010 establishing a DOD Task Force on the Care, Management, and Transition of Recovery, Wounded, Ill, and Injured Members of the Armed Forces to access policies and programs. This Task Force will be independent and in a position to monitor DOD and VA’s partnership initiatives for our wounded, ill, and injured service members and their families. The National Military Family Association encourages the all committees with jurisdiction over military personnel and veterans matters to talk on these important issues. We can no longer continue to create policies in a vacuum and be content on focusing on each agency separately because this population moves too frequently between the two agencies, especially our wounded, ill, and injured service members and their families.

FAMILY TRANSITIONS Survivors In the past year, the Services have been focusing on outreach to surviving families. In particular, the Army’s SOS (Survivor Outreach Services) program makes an effort to remind these families that they are not forgotten. DOD and the VA must work together to ensure surviving spouses and their children can receive the mental health services they need, through all of VA’s venues. New legislative language governing the TRICARE behavioral health benefit may also be needed to allow TRICARE coverage of bereavement or grief counseling. The goal is the right care at the right time for optimum treatment effect. DOD and the VA need to better coordinate their mental health services for survivors and their children. We thank Congress for extending the TRICARE Dental benefit to surviving children. We ask that eligibility be expanded to those active duty family members who had not been enrolled in the active duty TRICARE Dental benefit prior to the service member’s death. Our Association recommends that eligibility be expanded to active duty survivors who had not been enrolled in the TRICARE Dental Program prior to the service member’s death. We also recommend that grief counseling be more readily available to survivors. In 2009, the policy concerning the attendance of the media at the dignified transfer of remains at Dover AFB was changed. Primary next-of-kin (PNOK) of the service member who dies in theater is asked to make a decision shortly after they are notified of the loss as to whether or not the media may film the dignified transfer of remains of their loved one during this ceremony. Family members are also given the option of flying to Dover themselves to witness this ceremony. In previous years, only about 3 percent of family members attended this ceremony. Since the policy change, over 90 percent of families send some family members to Dover to attend. The travel of up to 3 family members and the casualty assistance officer on a commercial carrier are provided for. In the NDAA fiscal year 2010, eligible family member travel to memorial services for a service member who dies in theater was authorized. This is in addition to travel to the funeral of the service member. None of the costs associated with this travel has been funded for the Services. We would ask that funds be appropriated to cover the costs of this extraordinary expense. 513

We ask that funding be appropriated for the travel costs for surviving family members to attend the dignified transfer of remains in Dover and for eligible surviving family members to attend memorial services for service members who die in theater. Our Association still believes the benefit change that will provide the most significant long-term advantage to the financial security of all surviving families would be to end the Dependency and Indemnity Compensation (DIC) offset to the Survivor Benefit Plan (SBP). Ending this offset would correct an inequity that has existed for many years. Each payment serves a different purpose. The DIC is a special indemnity (compensation or insurance) payment paid by the VA to the survivor when the service member’s service causes his or her death. The SBP annuity, paid by DOD, reflects the longevity of the service of the military member. It is ordinarily calculated at 55 percent of retired pay. Military retirees who elect SBP pay a portion of their retired pay to ensure that their family has a guaranteed income should the retiree die. If that retiree dies due to a service connected disability, their survivor becomes eligible for DIC. Surviving active duty spouses can make several choices, dependent upon their circumstances and the ages of their children. Because SBP is offset by the DIC payment, the spouse may choose to waive this benefit and select the ‘‘child only’’ option. In this scenario, the spouse would receive the DIC payment and the children would receive the full SBP amount until each child turns 18 (23 if in college), as well as the individual child DIC until each child turns 18 (23 if in college). Once the children have left the house, this choice currently leaves the spouse with an annual income of $13,848, a significant drop in income from what the family had been earn- ing while the service member was alive and on active duty. The percentage of loss is even greater for survivors whose service members served longer. Those who give their lives for their country deserve more fair compensation for their surviving spouses. We believe several other adjustments could be made to the Survivor Benefit Plan. Allowing payment of the SBP benefits into a Special Needs Trust in cases of disabled beneficiaries will preserve their eligibility for income based support programs. The government should be able to switch SBP payments to children if a surviving spouse is convicted of complicity in the member’s death. We believe there needs to be DIC equity with other Federal survivor benefits. Currently, DIC is set at $1,154 monthly (43 percent of the Disabled Retirees Com- pensation). Survivors of Federal workers have their annuity set at 55 percent of their Disabled Retirees Compensation. Military survivors should receive 55 percent of VA Disability Compensation. We are pleased that the requirement for a report to assess the adequacy of DIC payments was included in the NDAA fiscal year 2009. We are awaiting the overdue report. We support raising DIC payments to 55 percent of VA Disability Compensation. When changes are made, ensure that DIC eligi- bles under the old system receive an equivalent increase. We ask the DIC offset to SBP be eliminated to recognize the length of commitment and service of the career service member and spouse. We also request that SBP benefits be allowed to be paid to a Special Needs Trust in cases of disabled family members. We ask that DIC be increased to 55 percent of VA Disability Compensation. Education of Military Children The National Military Family Association would like to thank Congress for including a ‘‘Sense of Congress’’ in regards to the Interstate Compact on Educational Op- portunity for Military Children in last year’s National Defense Authorization Act. The Compact has now been adopted in 30 states and covers over 84 percent of our military children. The Interstate Commission, the governing body of the Compact, is working to educate military families, educators, and states on the appropriate usage of the Compact. The adoption of the Compact is a tremendous victory for military families who place a high value on education. However, military families define the quality of that education differently than most states or districts that look only at issues within their boundaries. For military families, it is not enough for children to be doing well in their current schools, they must also be prepared for the next location. The same is true for children in underperforming school systems. Families are concerned that they will lag behind students in the next location. With many states cutting educational programs due to the economic downturn, this concern is growing. A prime example is Hawaii, which opted to furlough teachers on Fridays, cutting 17 days from the school calendar. With elementary schools already on a shortened schedule for Wednesday, these students are only getting approximately 31⁄2 days of instruction every other week. In addition, the recent cuts have made it increasing hard for schools to meet IEP re- 514 quirements for special needs students. Furthermore, Hawaii is requiring parents to pay more for busing, and the cost of school meals have gone up 76 percent. Our As- sociation believes that Hawaii’s cuts are just the ‘‘tip of the iceberg’’ as we are beginning to see other states make tough choices as well. Although Hawaii’s educational system has long been a concern for military families, many of whom opt for expensive private education, Hawaii is not the only place where parents have concerns. The National Military Family Association believes that our military children deserve to have a good quality education wherever they may live. However, our Asso- ciation recognizes that how that quality education is provided may differ in each location. We urge Congress to encourage solutions for the current educational situation across the nation and recognize that service members’ lack of confidence that their children may receive a quality education in an assignment location can affect the readiness of the force in that location. While our Association remains appreciative for the additional funding Congress provides to civilian school districts educating military children, Impact Aid continues to be under-funded. We urge Congress to provide appropriate and timely funding of Impact Aid through the Department of Education. In addition, we urge Congress to increase DOD Impact Aid funding for schools educating large numbers of military children to $60 million for fiscal year 2011. We also ask Congress to include an additional $5 million in funding for special needs children. The DOD supplement to Impact Aid is critically important to ensure school districts provide quality education for our military children. As increased numbers of military families move into new communities due to Global Rebasing and BRAC, their housing needs are being met further and further away from the installation. Thus, military children may be attending school in districts whose familiarity with the military lifestyle may be limited. Educating large numbers of military children will put an added burden on schools already hard- pressed to meet the needs of their current populations. We urge Congress to authorize an increase in this level of funding until BRAC and Global Rebasing moves are completed. Once again, we thank Congress for passing the Higher Education Opportunity Act of 2008, which contained many new provisions affecting military families. Chief among them was a provision to expand in-state tuition eligibility for military service members and their families, and provide continuity of in-state rates if the service member receives Permanent Change of Station (PCS) orders out of state. However, family members have to be currently enrolled in order to be eligible for continuity of in-state tuition. Our Association is concerned that this would preclude a senior in high school from receiving in-state tuition rates if his or her family PCS’s prior to matriculation. We urge Congress to amend this provision. We ask Congress to increase the DOD supplement to Impact Aid to $60 million to help districts better meet the additional demands caused by large numbers of military children, deployment-related issues, and the effects of military programs and policies. We also ask Congress to include an additional $5 million for school districts with Special Needs children. Spouse Education & Employment Our Association wishes to thank Congress for recent enhancement to spouse education opportunities. In-state tuition, Post 9/11 G.I. bill transferability to spouses and children, and other initiatives have provided spouses with more educational opportunities than previous years. Since 2004, our Association has been fortunate to sponsor our Joanne Holbrook Patton Military Spouse Scholarship Program, with the generosity of donors who wish to help military families. Our 2010 application period closed on January 31, 2010. We saw a 33 percent increase in applications from previous years with more than 8,000 military spouses applying to our program. Military spouses remain committed to their education and need assistance from Congress to fulfill their educational pursuits. We have heard from many military spouses who are pleased with the expansion of the Military Spouse Career Advancement Accounts, now called MyCAA. Unfortu- nately the abrupt halt of the program on February 16, 2010 created a financial burden and undue stress for military spouses. We are pleased DOD has reinstated the program for the 136,583 spouses enrolled in the program prior to February 16, 2010. We ask Congress to push DOD to fully restart this critical program for all eligible spouses as soon as possible. We also ask Congress to fully fund the MyCAA program, which is providing essential educational and career support to military spouses. The MyCAA program is not available to all military spouses. We ask Con- gress to work with the appropriate Service Secretary to expand this funding to the 515 spouses of Coast Guard, the Commissioned Corps of NOAA and U.S. Public Health Service. Our Association thanks you for establishing a pilot program to secure internships for military spouses with Federal agencies. Military spouses look forward to enhanced career opportunities through the pilot program. We hope Congress will monitor the implementation of the program to ensure spouses are able to access the program and eligible spouses are able to find Federal employment after successful completion of the internship program. To further spouse employment opportunities, we recommend an expansion to the Workforce Opportunity Tax Credit for employers who hire spouses of active duty and Reserve component service members, and to provide tax credits to military spouses to offset the expense in obtaining career licenses and certifications when service members are relocated to a new duty station within a different state. The Services are experiencing a shortage of medical, mental health and child care providers. Many of our spouses are trained in these professions or would like to seek training in these professions. We think the Services have an opportunity to create portable career opportunities for spouses seeking in-demand professions. In addition to the MyCAA funding, what can the Services do to encourage spouse employment and solve provider shortages? We would like to see the Services reach out to military spouses and offer affordable, flexible training programs in high demand professions to help alleviate provider shortages. Our Association urges Congress to recognize the value of military spouses by fully funding the MyCAA program, and by creating training programs and employment opportunities for military spouses in high demand professions to help fill our provider shortages. Families on the Move A PCS move to an overseas location can be especially stressful for our families. Military families are faced with the prospect of being thousands of miles from extended family and living in a foreign culture. At many overseas locations, there are insufficient numbers of government quarters resulting in the requirement to live on the local economy away from the installation. Family members in these situations can feel extremely isolated; for some the only connection to anything familiar is the local military installation. Unfortunately, current law permits the shipment of only one vehicle to an overseas location, including Alaska and Hawaii. Since most families today have two vehicles, they sell one of the vehicles. Upon arriving at the new duty station, the service member requires transportation to and from the place of duty leaving the military spouse and family members at home without transportation. This lack of transportation limits the ability of spouses to secure employment and the ability of children to participate in extra- curricular activities. While the purchase of a second vehicle alleviates these issues, it also results in significant expense while the family is already absorbing other costs associated with a move. Simply permitting the shipment of a second vehicle at government expense could alleviate this expense and acknowledge the needs of today’s military family. Travel allowances and reimbursement rates have not kept pace with the out-of- pocket costs associated with today’s moves. Military families are authorized 10 days for a housing hunting trip, but the cost for trip is the responsibility of the service member. Families with two vehicles may ship one vehicle and travel together in the second vehicle. The vehicle will be shipped at the service member’s expense and then the service member will be reimbursed funds not used to drive the second vehicle to help offset the cost of shipping it. Or, families may drive both vehicles and receive reimbursement provided by the Monetary Allowance in Lieu of Transpor- tation (MALT) rate. MALT is not intended to reimburse for all costs of operating a car but is payment in lieu of transportation on a commercial carrier. Yet, a TDY mileage rate considers the fixed and variable costs to operate a vehicle. Travel allowances and reimbursement rates should be brought in line with the actually out- of-pocket costs borne by military families. Our Association requests that Congress authorize the shipment of a second vehicle to an overseas location (at least Alaska and Hawaii) on accompanied tours, and that Congress address the out-of-pocket expenses military families bare for government ordered moves. Military Families—Our Nation’s Families We thank you for your support of our service members and their families and we urge you to remember their service as you work to resolve the many issues facing our country. Military families are our Nation’s families. They serve with pride, honor, and quiet dedication. Since the beginning of the war, government agencies, 516 concerned citizens and private organizations have stepped in to help. This increased support has made a difference for many service members and families, yet, some of these efforts overlap while others are ineffective. In our testimony, we believe we have identified improvements and additions that can be made to already successful programs while introducing policy or legislative changes that address the ever changing needs of our military population. Working together, we can improve the quality of life for all these families Chairman INOUYE. Our next witness is Dr. Dan Putka, American Psychological Association. Am I correct, Putka?

STATEMENT OF DAN PUTKA, Ph.D., ON BEHALF OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION Dr. PUTKA. Good morning, Mr. Chairman and Ranking Member Cochran. I am Dr. Dan Putka from HumRRO, the Human Resources Re- search Organization. I am submitting testimony on behalf of the American Psychological Association, or APA, a scientific and professional organization of more than 152,000 psychologists. For decades, clinical and research psychologists have used their unique and critical expertise to meet the needs of our military and its personnel, playing a vital role within the Department of De- fense. My own military-oriented research and consulting focus on the recruitment and retention of committed high-performing military personnel. This morning, I focus on APA’s request that Congress reverse disturbing administration cuts to DOD’s science and technology budget and maintain support for important behavioral sciences research through DOD’s Minerva Initiative. In the President’s proposed fiscal year 2011 budget, defense S&T would fall from the estimated fiscal year 2010 level of $14.7 billion to $12.3 billion, a decrease of 16.3 percent. All military labs would see cuts to their 6.2 and 6.3 applied research accounts, with some cuts as high as 49 percent, namely, the Army’s 6.3 account. Defense supported basic research, the 6.1 account, would fare better under the President’s budget, and APA supports the substantial increase proposed for the Defense-wide basic research program. But we are very concerned about the deep cuts to near-term research supported by the 6.2 and 6.3 program accounts. This is not the time to reduce support for research that is vital to our Nation’s continued security in a global atmosphere of uncertainty and asymmetric threats. APA urges the subcommittee to reverse this cut to the critical defense science program by providing $15 billion for defense S&T in fiscal year 2011. Within the S&T program, APA encourages the subcommittee to follow the recommendations from the National Academies and the Defense Science Board to fund priority research in the behavioral sciences in support of national security. Psychological scientists supported by the military labs address a broad range of important issues and problems vital to our national defense, with expertise in modeling behavior of individuals and groups, understanding and optimizing cognitive functioning, perceptual awareness, complex decisionmaking, stress resilience, recruitment and retention, military family functioning, and human systems interactions. Psychological scientists also have critical expertise in understanding extremist ideologies, radicalization processes, and 517 counterinsurgencies. And we hope you will join the House in re- newing your strong support for the DOD Minerva Initiative to address these and other compelling challenges. As noted in a recent National Research Council report, people are the heart of all military efforts. People operate the available weaponry and technology, and they constitute a complex military system composed of teams and groups at multiple levels. Scientific research on human behavior is crucial to the military because it provides knowledge about how people work together and use weapons and technology to extend and amplify their forces. Thank you for this opportunity. Chairman INOUYE. Doctor, as you may be well aware, it wasn’t too long ago when DOD did not fully recognize the worth of psychologists. They were not considered good enough to be in the star rank. But this subcommittee took the step to give psychologists the recognition they deserve. And as a result, we have much psychological research and psychologists on our staffs. So you can be assured that we won’t take a back seat to anything. Senator COCHRAN. Mr. Chairman, I think it is interesting to observe that the Minerva Initiative was established by Secretary Gates I think with the realization that a better understanding of extremist ideologies in the world today need the attention of the Department of Defense. So we have hopes that through funding programs like that, making sure there is enough money there to achieve our goals, we can improve the safety factor of service and of citizenship in our great country. Chairman INOUYE. I thank you very much, and I thank the panel. [The statement follows:]

PREPARED STATEMENT OF DAN J. PUTKA The American Psychological Association (APA) is a scientific and professional organization of more than 152,000 psychologists and affiliates. For decades, psychologists have played vital roles within the Department of De- fense (DOD), as providers of clinical services to military personnel and their families, and as scientific researchers investigating mission-targeted issues ranging from airplane cockpit design to counter-terrorism. More than ever before, psychologists today bring unique and critical expertise to meeting the needs of our military and its personnel. APA’s testimony will focus on reversing Administration cuts to the overall DOD Science and Technology (S&T) budget and maintaining support for important behavioral sciences research within DOD.

DOD RESEARCH ‘‘People are the heart of all military efforts. People operate the available weaponry and technology, and they constitute a complex military system composed of teams and groups at multiple levels. Scientific research on human behavior is crucial to the military because it provides knowledge about how people work together and use weapons and technology to extend and amplify their forces.’’———Human Behavior in Military Contexts Report of the National Research Council, 2008 Just as a large number of psychologists provide high-quality clinical services to our military service members stateside and abroad (and their families), psychological scientists within DOD conduct cutting-edge, mission-specific research critical to national defense.

BEHAVIORAL RESEARCH WITHIN THE MILITARY SERVICE LABS AND DOD Within DOD, the majority of behavioral, cognitive and social science is funded through the Army Research Institute (ARI) and Army Research Laboratory (ARL); 518 the Office of Naval Research (ONR); and the Air Force Research Laboratory (AFRL), with additional, smaller human systems research programs funded through the Of- fice of the Secretary of Defense (OSD) and the Defense Advanced Research Projects Agency (DARPA). The military service laboratories provide a stable, mission-oriented focus for science, conducting and sponsoring basic (6.1), applied/exploratory development (6.2) and advanced development (6.3) research. These three levels of research are roughly parallel to the military’s need to win a current war (through products in advanced development) while concurrently preparing for the next war (with technology ‘‘in the works’’) and the war after next (by taking advantage of ideas emerging from basic research). All of the services fund human-related research in the broad categories of personnel, training and leader development; warfighter protection, sustainment and physical performance; and system interfaces and cognitive processing. National Academies Report Calls for Doubling Behavioral Research The 2008 National Academies report on Human Behavior in Military Contexts recommended doubling the current budgets for basic and applied behavioral and social science research ‘‘across the U.S. military research agencies.’’ It specifically called for enhanced research in six areas: intercultural competence; teams in complex environments; technology-based training; nonverbal behavior; emotion; and behavioral neurophysiology. Behavioral and social science research programs eliminated from the mission labs due to cuts or flat funding are extremely unlikely to be picked up by industry, which focuses on short-term, profit-driven product development. Once the expertise is gone, there is absolutely no way to ‘‘catch up’’ when defense mission needs for critical human-oriented research develop. As DOD noted in its own Report to the Sen- ate Appropriations Committee: ‘‘Military knowledge needs are not sufficiently like the needs of the private sector that retooling behavioral, cognitive and social science research carried out for other purposes can be expected to substitute for service-supported research, development, testing, and evaluation...our choice, therefore, is between paying for it ourselves and not having it.’’ Defense Science Board Calls for Priority Research in Social and Behavioral Sciences This emphasis on the importance of social and behavioral research within DOD is echoed by the Defense Science Board (DSB), an independent group of scientists and defense industry leaders whose charge is to advise the Secretary of Defense and the Chairman of the Joint Chiefs of Staff on ‘‘scientific, technical, manufacturing, acquisition process, and other matters of special interest to the Department of De- fense.’’ In its report on 21st Century Strategic Technology Vectors, the DSB identified a set of four operational capabilities and the ’’enabling technologies’’ needed to accomplish major future military missions (analogous to winning the Cold War in previous decades). In identifying these capabilities, DSB specifically noted that ‘‘the report defined technology broadly, to include tools enabled by the social sciences as well as the physical and life sciences.’’ Of the four priority capabilities and corresponding areas of research identified by the DSB for priority funding from DOD, the first was defined as ‘‘mapping the human terrain’’—understanding the human side of warfare and national security.

FISCAL YEAR 2011 DOD BUDGET FOR SCIENCE AND TECHNOLOGY DOD In terms of the overall DOD S&T budget, the President’s request for fiscal year 2011 again represents a dramatic step backward for defense research. Defense S&T would fall from the estimated fiscal year 2010 level of $14.7 billion to $12.3 billion (a decrease of 16.3 percent). All military labs would see cuts to their 6.2 and 6.3 research accounts, with some cuts as high as 49 percent (the Army’s 6.3 account). Defense-supported basic research (6.1 level accounts) would fare better under the President’s budget, and APA supports the substantial increase proposed for the OSD’s Defense-wide basic research program, but we are very concerned about the deep cuts to near-term research supported by the 6.2 and 6.3 program accounts. DARPA DARPA’s overall funding would increase only slightly in the President’s fiscal year 2011 budget, from $3 billion to $3.1 billion. The agency’s home for basic research, the Defense Research Sciences Account, however, would be strengthened significantly. APA supports DARPA’s transformative sciences priorities for this account, which include research that taps ‘‘converging technological forces and trans- 519 formational trends in the areas of computing and the computing-reliant subareas of social sciences, life sciences, manufacturing and commerce.’’

FOCUS FOR MINERVA RESEARCH APA was pleased to see the House Armed Services Committee note (in the fiscal year 2011 National Defense Authorization Act) its support for ‘‘the use of social science to support key DOD missions such as irregular warfare, counterinsurgency, and stability and reconstruction operations’’ through research funded by the DOD Minerva initiative established by Secretary Gates. APA agrees with the House that DOD ‘‘has not provided enough focus for the Minerva initiative to develop a deep enough expertise in any of its seven topic areas,’’ especially in ‘‘understanding the extremist ideologies that help fuel recruitment of terrorists.’’ APA supports the fiscal year 2011 NDAA authorization of $96.2 million, $5 million above the President’s budget request, for DOD to conduct Minerva initiative research to improve our understanding of extremist ideologies.

SUMMARY The President’s budget request for basic and applied research at DOD in fiscal year 2011 is $12.3 billion, which represents a dramatic cut of $2.4 billion or 16 percent from the enacted fiscal year 2010 level of $14.7 billion. APA urges the Sub- committee to reverse this cut to the critical defense science program by providing a total of $15 billion for Defense S&T in fiscal year 2011. APA supports the substantial increases to DOD’s and DARPA’s basic research portfolios, but joins the Coalition for National Security Research in urging Congress to provide sufficient overall funding to reach the Pentagon’s goal of investing 3 percent of DOD’s total budget in Defense S&T. Within the S&T program, APA encourages the Subcommittee to follow recommendations from the National Academies and the Defense Science Board to fund priority research in the behavioral sciences in support of national security. Clearly, psychological scientists address a broad range of important issues and problems vital to our national defense, with expertise in modeling behavior of individuals and groups, understanding and optimizing cognitive functioning, perceptual awareness, complex decision-making, stress resilience, recruitment and retention, and human- systems interactions. We urge you to support the men and women on the front lines by reversing another round of cuts to the overall defense S&T account and the human-oriented research projects within the military laboratories. As our nation rises to meet the challenges of current engagements in Iraq and Afghanistan as well as other asymmetric threats and increased demand for homeland defense and infrastructure protection, enhanced battlespace awareness and warfighter protection are absolutely critical. Our ability to both foresee and immediately adapt to changing security environments will only become more vital over the next several decades. Accordingly, DOD must support basic Science and Tech- nology (S&T) research on both the near-term readiness and modernization needs of the department and on the long-term future needs of the warfighter. Below is suggested appropriations report language for fiscal year 2011 which would encourage the Department of Defense to fully fund its behavioral research programs within the military laboratories and the Minerva initiative:

DEPARTMENT OF DEFENSE

RESEARCH, DEVELOPMENT, TEST, AND EVALUATION The Minerva Initiative and Behavioral Research in the Military Service Labora- tories.—The Committee notes the increased demands on our military personnel, including high operational tempo, leadership and training challenges, new and ever- changing stresses on decision-making and cognitive readiness, and complex human- technology interactions. To help address these issues vital to our national security, the Committee has provided increased funding to reverse cuts to psychological research through the military research laboratories: the Air Force Office of Scientific Research and Air Force Research Laboratory; the Army Research Institute and Army Research Laboratory; and the Office of Naval Research. The Committee also notes the critical contributions of behavioral science to combating counterinsurgencies and understanding extremist ideologies, and renews its strong support for the DOD Minerva initiative. Chairman INOUYE. And now I would like to proceed to the third panel, consisting of Dr. John C. Elkas, Mr. Richard ‘‘Rick’’ A. Jones, Ms. Elizabeth Cochran, and Dr. Jonathan Berman. 520 May I recognize Dr. John C. Elkas.

STATEMENT OF JOHN C. ELKAS, M.D., J.D., ON BEHALF OF THE SOCI- ETY OF GYNECOLOGIC ONCOLOGISTS Dr. ELKAS. Mr. Chairman and Vice Chairman, thank you for inviting me to testify at today’s hearing. My name is Dr. John Elkas, and I am here on behalf of the Soci- ety of Gynecologic Oncologists. The SGO is a national medical specialty organization of physicians who are trained in the comprehensive care and management of women with gynecologic malignancies. I also practice medicine in the D.C. metropolitan area and am a commander in the United States Naval Reserve and an adjunct associate professor of obstetrics and gynecology for the Uniformed Services University of the Health Sciences. I spent 14 years in Active Duty service caring for women within the Department of Defense family with ovarian cancer, and I can speak personally to the impact that the OCRP is having on the care of military women with ovarian cancer. I am honored to be here and pleased that this subcommittee is focusing its attention on the OCRP. Since its inception now 13 years ago, this DOD program has delivered benefits to ovarian cancer research that far exceed the annual level of Federal funding. As this subcommittee knows, ovarian cancer causes more deaths than any other gynecologic malignancy and is the fourth highest cause of cancer death among American women. One of our biggest challenges lie in the fact that only 20 percent of ovarian cancer is detected at an early stage, while most of our patients are diagnosed at an advanced stage, where we heard the 5 year survival is markedly lower. We, the members of the SGO, along with our patients who are battling this disease every day, depend on the OCRP research funding. It is through this type of research funding that a screening and early detection method for ovarian cancer can be identified, which will allow us to save as many as 15,000 lives each year in the United States. Since its inception in fiscal year 1997, the OCRP has funded 209 grants, totaling more than $140 million. Much of this has been accomplished with the resources that we are talking about today. In Senator Mikulski’s home State of Maryland, where many of my patients also live, the OCRP has funded research on important questions such as defining bio-markers that could be fundamental to development of a blood test for early-stage disease and developing and evaluating alpha target based approach for also treating advanced disease. In Senator Murray’s home State of Washington, where five OCRP-funded grants reside, questions such as the development of blood tests for new small molecules in the blood that might be used for detection and the examination of all women—of all of a woman’s DNA to find new genes or groups of genes that may cause ovarian cancer in families. In Senator Feinstein’s home State of California, 24 grants have been funded by the OCRP since the program was created in 1997, 521 looking at questions such as inhibiting—strategies for targeting and inhibiting tumor growth, identification of cancer stem cells. So, as you can see, these are just a few examples of the 209 grants that have served as a catalyst for attracting outstanding researchers to the field of ovarian cancer research. Investigators funded by the OCRP have succeeded with several crucial breakthroughs in bringing us closer in both the prevention and early detection of ovarian cancer. Were it not for this, many researchers might have abandoned their hopes of a career in basic and translational research in ovarian cancer. Therefore, the Society of Gynecologic Oncologists joins with the Ovarian Cancer National Alliance and the American Congress of Obstetricians and Gynecologists to urge this subcommittee to increase Federal funding to a minimum of $30 million in fiscal year 2011 for the OCRP. Thank you, gentlemen. Chairman INOUYE. I thank you very much, Doctor. On a personal note, 4 years ago, I lost my wife of 57 years to cancer of the liver. So this matter is a matter of personal interest. So I can assure you this subcommittee supports it. Senator COCHRAN. Thank you very much. I notice that the request is that we fund the program at $30 million. What is the current level of funding, do you recall? Dr. ELKAS. $18.7 million, sir. Senator COCHRAN. Okay. Thank you. Chairman INOUYE. Thank you very much, Doctor. [The statement follows:]

PREPARED STATEMENT OF JOHN C. ELKAS Mr. Chairman, Ranking Member and members of the subcommittee, thank you for inviting me to testify at today’s hearing. My name is Dr. John C. Elkas, and I am Vice Chairman of the Bylaws Committee and a former member of the Govern- ment Relations Committee of the Society of Gynecologic Oncologists (SGO). I practice medicine in the D.C.-metropolitan area, where I am an associate clinical professor in the department of obstetrics and gynecology at the George Washington University Medical Center and in private practice in Annandale, Virginia. I am also a Commander in the U.S. Naval Reserve and an adjunct associate professor of obstetrics and gynecology for the Uniformed Services University of the Health Sciences in Bethesda, Maryland. I am honored to be here and pleased that this subcommittee is focusing attention on the Department of Defense (DOD) Congressionally Directed Medical Research Program in Ovarian Cancer (OCRP). Since its inception now 13 years ago, this DOD program has delivered benefits to ovarian cancer research that far exceed the annual level of Federal funding. This morning, I will try to outline some of the important contributions this DOD program has made to ovarian cancer research and the well-being of our patients. In fact, it is quite easy to demonstrate that this investment by the Federal government has resulted in substantial benefits and value to medicine, to science and most importantly improved patient care. As this subcommittee may know, ovarian cancer usually arises from the cells on the surface of the ovary and can be extremely difficult to detect. According to the American Cancer Society, in 2009, more than 21,500 women were diagnosed with ovarian cancer and approximately 15,000 lost their lives to this terrible disease. Ovarian cancer causes more deaths than all the other cancers of the female repro- ductive tract combined, and is the fourth highest cause of cancer deaths among American women. One of our biggest challenges lies in the fact that only 19 percent of all ovarian cancers are detected at a localized stage, when the 5-year relative survival rate approaches 93 percent. Unfortunately, most ovarian cancer is diagnosed at late or advanced stage, when the 5-year survival rate is only 31 percent. 522

Nationally, biomedical research funding has grown over the last decade through increased funding to the National Institutes of Health, in no small part to the amazing efforts of members of this Subcommittee. Yet funding for gynecologic cancer research, especially for the deadliest cancer that we treat, ovarian cancer, has been relatively flat. Since fiscal year 2003, the funding levels for gynecologic cancer research and training programs at the NIH, NCI, and CDC have not kept pace with inflation, with the funding for ovarian cancer programs and research training for gynecologic oncologists actually suffering specific cuts in funding due to the loss of an ovarian cancer Specialized Project of Research Excellence (SPORE) in 2007 that had been awarded to a partnership of DUKE and the University of Alabama-Bir- mingham. Were it not for the DOD OCRP, many researchers might have abandoned their hopes of a career in basic and translation research in ovarian cancer and our patients and the women of America would be waiting even longer for reliable screening tests and more effective therapeutic approaches. As a leader in the Society of Gynecologic Oncologists (SGO) and as a gynecologic oncologist who has provided care to women affiliated with the United States Navy, I believe that I bring a comprehensive perspective to our request for increased support. The SGO is a national medical specialty organization of physicians who are trained in the comprehensive management of women with malignancies of the re- productive tract. Our purpose is to improve the care of women with gynecologic cancer by encouraging research, disseminating knowledge which will raise the standards of practice in the prevention and treatment of gynecologic malignancies and cooperating with other organizations interested in women’s healthcare, oncology and related fields. The Society’s membership, totaling more than 1,300, is comprised of gynecologic oncologists, as well as other related women’s cancer healthcare specialists including medical oncologists, radiation oncologists, nurses, social workers and pathologists. SGO members provide multidisciplinary cancer treatment including surgery, chemotherapy, radiation therapy, and supportive care. More information on the SGO can be found at www.sgo.org. We, the members of the SGO, along with our patients who are battling ovarian cancer every day, depend on the DOD OCRP research funding. It is through this type of research funding that a screening and early detection method for ovarian cancer can be identified which will allow us to save many of the 15,000 lives that are lost to this disease each year. Therefore, the SGO respectfully recommends that this Subcommittee provide the DOD OCRP with a minimum of $30 million in Fed- eral funding for fiscal year 2011.

DEPARTMENT OF DEFENSE OVARIAN CANCER RESEARCH PROGRAM: BUILDING AN ARMY OF OVARIAN CANCER RESEARCHERS New Investigators Join the Fight Since its inception in fiscal year 1997, the DOD OCRP has funded 209 grants totaling more than $140 million in funding. The common goal of these research grants has been to promote innovative, integrated, and multidisciplinary research that will lead to prevention, early detection, and ultimately control of ovarian cancer. Much has been accomplished in the last decade to move us forward in achieving this goal. In Senator Mikulski’s home state of Maryland, where many of my patients also live, the DOD OCRP has funded research on important questions such as: —Defining biomarkers of serous carcinoma, using molecular biologic and immunologic approaches, which are critical as probes for the etiology/patho- genesis of ovarian cancer. Identifying biomarkers is fundamental to the development of a blood test for diagnosis of early stage disease and also ovarian cancer- specific vaccines; —Developing and evaluating a targeted alpha-particle based approach for treating disseminated ovarian cancer. Alpha-particles are short-range, very potent emissions that kill cells by incurring damage that cannot be repaired; one to three alpha-particles tracking through a cell nucleus can be enough to kill a cell. The tumor killing potential of alpha-particles is not subject to the kind of resistance that is seen in chemotherapy; and —Understanding of the molecular genetic pathways involved in ovarian cancer development leading to the identification of the cancer-causing genes (‘‘oncogenes’’) for ovarian cancer. In Senator Murray’s home state of Washington, the DOD OCRP has funded five grants in the last 5 years to either the University of Washington or to the Fred Hutchinson Cancer Center to study research questions regarding: —The usefulness of two candidate blood-based microRNA markers for ovarian cancer detection, and the identification of microRNAs produced by ovarian can- 523

cer at the earliest stages, which may also be the basis for future blood tests for ovarian cancer detection; —The first application of complete human genome sequencing to the identification of genes for inherited ovarian cancer. The identification of new ovarian cancer genes will allow prevention strategies to be extended to hundreds of families for which causal ovarian cancer genes are currently unknown; and —Proposed novel technology, stored serum samples, and ongoing clinical studies, with the intend of developing a pipeline that can identify biomarkers that have the greatest utility for women; biomarkers that identify cancer early and work well for the women in most need of early detection, that can immediately be evaluated clinically. One of the first, and very successful, grant recipients from the DOD OCRP hails from the Fred Hutchinson Cancer Research Center in Seattle, WA, Dr. Nicole Urban. Dr. Urban has worked extensively in the field of ovarian cancer early detection biomarker discovery and validation. Her current program in translational ovarian cancer research was built on work funded in fiscal year 1997 by the OCRP, ‘‘Use of Novel Technologies to Identify and Investigate Molecular Markers for Ovarian Cancer Screening and Prevention.’’ Working with Beth Karlan, M.D. at Cedars-Sinai and Leroy Hood, Ph.D., M.D. at the University of Washington, she identified novel ovarian cancer biomarkers including HE4, Mesothelin (MSLN), and SLPI using comparative hybridization methods. This discovery lead to funding in 1999 from the National Cancer Institute (NCI) for the Pacific Ovarian Cancer Research Consor- tium (POCRC) Specialized Program of Research Excellence (SPORE) in ovarian cancer. The DOD and NCI funding allowed her to develop resources for translational ovarian cancer research including collection, management, and allocation of tissue and blood samples from women with ovarian cancer, women with benign ovarian conditions, and women with healthy ovaries. The DOD grant provided the foundation for what is now a mature specimen repository that has accelerated the progress of scientists at many academic institutions and industry. In Senator Feinstein’s home state of California, 24 grants have been funded by the DOD OCRP since the program was created in 1997 to study research questions such as: —Strategies for targeting and inhibiting a protein called focal adhesion kinase (FAK) that promotes tumor growth-metastasis. With very few viable treatment options for metastatic ovarian cancer, this research could lead to drug development targeting these types of proteins; —Developing a tumor-targeting drug delivery system using Nexil nanoparticles that selectively adhere to and are ingested by ovarian carcinoma cells following injection into the peritoneal cavity. The hypothesis for this research is that the selectivity of Nexil can be substantially further improved by attaching peptides that cause the particle to bind to the cancer cells and that this will further increase the effectiveness of intraperitoneal therapy; and —Using several avenues of investigation, based on our understanding of the biology of stem cells, to identify and isolate cancer stem cells from epithelial ovarian cancer. This has significant implications for our basic scientific understanding of ovarian cancer and may drastically alter treatment strategies in the near future. Therapies targeted at the cancer stem cells offer the potential for long-term cures that have eluded most patients with ovarian cancer. In Senator Hutchinson’s home state of Texas, 19 grants have been funded since the inception of the DOD OCRP in 1997, to study research questions regarding: —Understanding the pre-treatment genomic profile of ovarian cancer to then isolate the predictive response of the cancer to anti-vasculature treatment, possibly leading to the identification of targets for novel anti-vasculature therapies; —Ovarian cancer development directly in the specific patient and her own tumor. While this process has lagged behind in ovarian cancer and improving patient outcomes, it has shown great promise in other solid, tumor cancers; and —Identifying the earliest molecular changes associated with BRCA1- and BRCA2- related and sporadic ovarian cancers, leading to biomarker identification for early detection. As you can see from these few examples, the 209 grants have served as a catalyst for attracting outstanding scientists to the field of ovarian cancer research. In the 4 year period of fiscal year 1998-fiscal year 2001 the OCRP enabled the recruitment of 29 new investigators into the area of ovarian cancer research. Federally Funding is Leveraged Through Partnerships and Collaborations In addition to an increase in the number of investigators, the dollars appropriated over the last 13 years have been leveraged through partnerships and collaborations 524 to yield even greater returns, both here and abroad. Past-President of the SGO, Dr. Andrew Berchuck of Duke University Medical Center leveraged his OCRP DOD grants to form an international Ovarian Cancer Association Consortium (OCAC) that is now comprised of over 20 groups from all across the globe. The consortium meets biannually and is working together to identify and validate single nucleotide polymorphisms (SNPs) that affect disease risk through both candidate gene approaches and genome-wide association studies (GWAS). OCAC reported last year in Nature Genetics the results of the first ovarian cancer GWAS, which identified a SNP in the region of the BNC2 gene on chromosome 9 (Nature Genetics 2009, 41:996–1000.) Dr. Berchuck and his colleagues in the association envision a future in which reduction of ovarian cancer incidence and mortality will be accomplished by implementation of screening and prevention interventions in women at moderately increased risk. Such a focused approach may be more feasible than population-based approaches, given the relative rarity of ovarian cancer. The DOD OCRP program also serves the purpose of strengthening U.S. relationships with our allies, such as Australia, the United Kingdom, and Canada. Dr. Peter Bowtell, from the Peter MacCallum Cancer Centre in Melbourne, Australia, was awarded a fiscal year 2000 Ovarian Cancer Research Program (OCRP) Program Project Award to study the molecular epidemiology of ovarian cancer. With funds from this award, he and his colleagues formed the Australian Ovarian Cancer Study (AOCS), a population-based cohort of over 2,000 women with ovarian cancer, including over 1,800 with invasive or borderline cancer. With a bank of over 1,100 fresh- frozen tumors, hundreds of formalin-fixed, paraffin-embedded (FFPE) blocks, and very detailed clinical follow-up, AOCS has enabled over 60 projects since its inception, including international collaborative studies in the United States, United King- dom, and Canada. AOCS has facilitated approximately 40 publications, most of which have been released in the past 2 years. One last important example of the value of the DOD OCRP’s contribution to science is the program’s focus on inviting proposals from the Historically Black Col- leges and Universities and Minority-Serving Institutions. This important effort to reach beyond established clinical research partnerships expands the core research infrastructure for these institutions which helps them to attract new investigators, leveraging complementary initiatives, and supporting collaborative ventures. Over the decade that the OCRP has been in existence, the 209 grantees have used their DOD funding to establish an ovarian cancer research enterprise that is much greater in value than the annually appropriated Federal funding. Opportunities are Lost Because of Current Level of Federal Funding These examples of achievement are obscured to a great degree by opportunities that have been missed. At this current level of funding, this is only a very small portion of what the DOD OCRP program could do as we envision a day where through prevention, early detection, and better treatments, ovarian cancer is a manageable and frequently curable disease. Consistently, the OCRP receives over 500 letters of intent for the annual funding cycle. Of this group, about 50 percent are invited to submit full proposals. Prior to fiscal year 2009, the OCRP was only able to fund approximately 16 grants per year, a pay line of less than 7 percent. With an increase in funding to $20 million in fiscal year 2009, the OCRP was able to fund 22 awards. However, for fiscal year 2010 the program was cut by $1.25 million and so the possibility of the OCRP being able to fund even 20 grantees is in jeopardy. To provide sufficient and effective funding to enable us to do our jobs and create an environment where our scientific research can succeed, we need a minimum investment of $30 million in fiscal year 2011.

DEPARTMENT OF DEFENSE OVARIAN CANCER RESEARCH PROGRAM: EXEMPLARY EXECUTION WITH REAL WORLD RESULTS Integration Panel Leads to Continuous Evaluation and Greater Focus By using the mechanism of an Integration Panel to provide the two-tier review process, the OCRP is able to reset the areas of research focus on an annual basis, thereby actively managing and evaluating the OCRP current grant portfolio. Gaps in ongoing research can be filled to complement initiatives sponsored by other agencies, and most importantly to fund high risk/high reward studies that take advantage of the newest scientific breakthroughs that can then be attributed to prevention, early detection and better treatments for ovarian cancer. An example of this happened in Senator Mikulski’s and my home state of Maryland regarding the development of the OVA1 test, a blood test that can help physicians determine if a woman’s pelvic mass is at risk for being malignant. The investigator, Zhen Zhang, 525

Ph.D. at Johns Hopkins School of Medicine, received funding from an Idea Develop- ment Award in fiscal year 2003. Dr. Zhang discovered and validated five serum biomarkers for the early detection of ovarian cancer. This bench research was then translated and moved through clinical trials. The OVA test was approved by the FDA and is now available to clinicians for use in patient care. More Than a Decade of Scientific Success The program’s successes have been documented in numerous ways, including 469 publications in professional medical journals and books; 576 abstracts and presentations given at professional meetings; and 24 patents, applications and licenses granted to awardees of the program. Investigators funded by the OCRP have succeeded with several crucial breakthroughs in bringing us closer to an algorithm for use in prevention and early detection of ovarian cancer. The Society of Gynecologic Oncologists joins with the Ovarian Cancer National Al- liance and the American Congress of Obstetricians and Gynecologists to urge this Subcommittee to increase Federal funding at a minimum to $30 million in fiscal year 2011 for the OCRP. This will allow for the discoveries and research breakthroughs in the first decade of this program to be further developed and expanded upon, hopefully bringing us by the end of the second decade of this program to our ultimate goal of prevention, early detection and finally elimination of ovarian cancer. I thank you for your leadership and the leadership of the Subcommittee on this issue. Chairman INOUYE. Now may I recognize Mr. Richard A. Jones.

STATEMENT OF RICHARD A. JONES, LEGISLATIVE DIRECTOR, NA- TIONAL ASSOCIATION FOR UNIFORMED SERVICES Mr. JONES. Chairman Inouye, Vice Chairman Cochran, thank you for the opportunity to give our views on key issues under your consideration. The National Association for Uniformed Services is pleased with certain aspects of the President’s budget, specifically those that laser-focus on winning the wars in Iraq and Afghanistan. Choosing to win these wars, however, should not mean we must depend on aging fleets of aircraft, ships, and vehicles across the services. We must continue toward modernization. One of the main messages our members want you to hear is really simple and direct. Anyone who goes into harm’s way under the flag of the United States needs to be deployed with the best our Nation can provide, and we must never cut off or unnecessarily delay critical funding for our troops in the field. Regarding TRICARE, the provision of quality, timely healthcare is considered one of the most important earned benefits afforded to those who serve a career in the military. The TRICARE benefit reflects the commitment of a nation, and it deserves your wholehearted support. For those who give their career in uniformed service now asks you to provide full funding to secure their earned benefit. The administration recommends a 1.4 percent across-the-board pay raise. My association asks you to seek an increase of 0.5 percent above the administration’s request, to 1.9 percent. We should clearly recognize the risks our men and women in uniform face, and we should make every effort to appropriately compensate them for the job they do. My association urges you also to provide adequate funding for military construction and family housing accounts. These funds for base allowance and housing should ensure that those serving in our military are able to afford to live in quality housing whether on or off the base. 526 The long war fought by an overstretched force gives us a clear warning. There are simply too many missions and too few troops. In addition to increasing troop strength, priority must be given to funding for accounts to reset, recapitalize, and renew the force. The National Guard, for example, has virtually depleted its equipment inventory, causing rising concern about its capacity to respond to disasters at home or train for the missions abroad. Regarding Walter Reed—that is a matter of great interest to our members as we plan to realign our health facilities in the Nation’s capital—we need to keep Walter Reed open as long as it is necessary to care for those who are at Walter Reed. We must not close Walter Reed prematurely. My association encourages the subcommittee to ensure that funding for Defense Department’s prosthetic research is adequate to support the full range of programs needed to meet current and future health challenges facing wounded veterans. Traumatic brain injury is the signature injury of the Iraq war. We call on the subcommittee to fund a full spectrum of TBI care and to recognize that care is also needed for patients suffering from mild to moderate brain injuries. The approach to this problem requires resources for hiring caseworkers, doctors, nurses, clinicians, and general caregivers if we are to meet the needs of those who are wounded and their families. Post traumatic stress disorder (PTSD) is a very serious psychiatric disorder. Pre-deployment and post-deployment checkups are very important. Early recognition of the symptoms can serve a great deal toward recovery. We encourage the members of the subcommittee, Mr. Chairman, to provide these funds, to closely monitor their expenditure to ensure they are not directed to areas of other defense spending. The Armed Forces Retirement Homes are important to those who have served in the military at Washington, DC, and Gulfport, Mis- sissippi. We look forward to the reopening of the Gulfport home in October, and we ask that you continue care for those programs. Mr. Chairman, Vice Chairman, thank you very much for the opportunity to present testimony today. Chairman INOUYE. I thank you very much. This subcommittee, as some may be aware, has appropriated nearly $1 trillion in the last 10 years to support our efforts in Af- ghanistan and Iraq. And we have done so without hesitation because we want our men to return home in as good a condition as they were when they went in there. But this has been a costly activity, but we will keep on paying. So I can assure you that your recommendations will be seriously considered. Mr. JONES. We thank you for the supplemental speed—supplemental bill and the speed that you handled that, sir. We hope that the House follows your suit. Senator COCHRAN. Mr. Chairman, I can report that the Armed Forces Retirement Home in Gulfport, Mississippi, is nearing completion of the reconstruction that has been going on, and they are expecting to open that home in October 2010. Mr. JONES. Excellent. Thank you, sir. Chairman INOUYE. We will go to the opening. 527 [The statement follows:]

PREPARED STATEMENT OF RICK JONES Chairman Inouye, Ranking Member Cochran, and members of the Subcommittee: It is a pleasure to appear before you today to present the views of The National Association for Uniformed Services on the fiscal year 2011 Defense Appropriations Bill. My name is Rick Jones, Legislative Director of The National Association for Uni- formed Services (NAUS). And for the record, NAUS has not received any Federal grant or contract during the current fiscal year or during the previous 2 fiscal years in relation to any of the subjects discussed today. As you know, the National Association for Uniformed Services, founded in 1968, represents all ranks, branches and components of uniformed services personnel, their spouses and survivors. The Association includes personnel of the active, retired, Reserve and National Guard, disabled veterans, veterans community and their families. We love our country and our flag, believe in a strong national defense, support our troops and honor their service. Mr. Chairman, the first and most important responsibility of our government is the protection of our citizens. As we all know, we are at war. That is why the defense appropriations bill is so very important. It is critical that we provide the resources to those who fight for our protection and our way of life. We need to give our courageous men and women everything they need to prevail. And we must recognize as well that we must provide priority funding to keep the promises made to the generations of warriors whose sacrifice has paid for today’s freedom. Presently, we have under consideration the President’s fiscal year 2011 defense budget request of $708 billion for its discretionary and war funding. According to the Defense Department, this represents an increase of 3.4 percent from the previous year. In fact, however, that’s about 1.8 percent real growth after inflation. Last year, we heard Defense Secretary Gates order the Defense Department to come up with $60 billion in cuts over the next 5 years. In fact, certain Members of Congress are calling for cuts in defense spending. In certain quarters of Congress, congressional leaders have recommended a 25 percent cut in the defense budget. The National Association for Uniformed Services is pleased with certain aspects of the President’s recommendation, specifically those that laser focus on winning the wars in Iraq and Afghanistan. Choosing to win these wars, however, should not mean our country must assume greater risk in conventional national defense challenges or neglect to consider the very real emerging threats of the future. We simply must have a strong investment in the size and capability of our air, land and naval forces. And we must invest in fielding new weapons systems today to meet the challenges of tomorrow. We cannot depend on aging fleets of aircraft, ships and vehicles across the services. We must continue to drive towards modernization and make available the resources we will need to meet and defeat the next threats to our security. Our nation is protected by the finest military the world has ever seen. The message our members want you to hear is simple and direct: Any one who goes into harm’s way under the flag of the United States needs to be deployed with the best our nation can provide. We need to give our brave men and women everything they need to succeed. And we must never cut off or unnecessarily delay critical funding for our troops in the field. The National Association for Uniformed Services is very proud of the job this generation of Americans is doing to defend America. Every day they risk their lives, half a world away from loved ones. Their daily sacrifice is done in today’s voluntary force. What they do is vital to our security. And the debt we owe them is enormous. Our Association also carries concerns about a number of related matters. Among these is the provision of a proper healthcare for the military community and recognition of the funding requirements for TRICARE for retired military. Also, we will ask for adequate funding to improve the pay for members of our armed forces and to address a number of other challenges including TRICARE Reserve Select and the Survivor Benefit Plan. We also have a number of related priority concerns such as the diagnosis and care of troops returning with Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), the need for enhanced priority in the area of prosthetics research, and providing improved seamless transition for returning troops between the Department of Defense (DOD) and the Department of Veterans Affairs (VA). In addition, we would like to ensure that adequate funds are provided to defeat injuries from the enemy’s use of Improvised Explosive Devices (IEDs). 528

TRICARE and Military Quality of Life: Health Care Quality healthcare is a strong incentive to make military service a career. The provision of quality, timely care is considered one of the most important benefits afforded the career military. The TRICARE benefit, earned through a career of service in the uniformed services, reflects the commitment of a nation, and it deserves your wholehearted support. It should also be recognized that discussions have once again begun on increasing the retiree-paid costs of TRICARE earned by military retirees and their families. We remember the outrageous statement of Dr. Gail Wilensky, a co-chair of the Task Force on the Future of Military, calling congressional passage of TRICARE for Life ‘‘a big mistake.’’ And more recently, we heard Admiral Mike Mullen, the current Chairman of Joint Chiefs of Staff, call for increases in TRICARE fees. Mullen said, ‘‘It’s a given as far as I’m concerned.’’ Fortunately, President Obama has taken fee increases off the table this year in the Administration budget recommendation. However, with comments like these from those in leadership positions, there is little wonder that retirees and active duty personnel are concerned. Seldom has NAUS seen such a lowing in confidence about the direction of those who manage the program. Faith in our leadership continues, but it is a weakening faith. And unless something changes, it is bound to affect recruiting and retention, even in a down economy. Criminal Activity Costs Medicare and TRICARE Billions of Dollars Recent testimony and studies from the Government Accountability Office (GAO), the investigative arm of the United States Congress, show us that at least $80 billion worth of Medicare money is being ripped off every year. Frankly, it demonstrates that criminal activity costs Medicare and TRICARE billions of dollars. Here are a couple of examples. GAO reports that one company billed Medicare for $170 million for HIV drugs. In truth, the company dispensed less than $1 million. In addition, the company billed $142 million for nonexistent delivery of supplies and parts and medical equipment. In another example, fake Medicare providers billed Medicare for prosthetic arms on people who already have two arms. The fraud amounted to $1.4 billion of bills for people who do not need prosthetics. TRICARE is closely tied to Medicare and its operations are not immune. Accord- ing to officials at the TRICARE Program Integrity Office, approximately 10 percent of all healthcare expenditures are fraudulent. With a military health system annual cost of $51 billion, fraudulent purchase of care in the military health system would amount to more than $5 billion. We need action to corral fraud and bring it to an end. What we’ve seen, however, is delay and second-hand attention with insufficient resources dedicated to TRICARE fraud conviction and recovery of money paid to medical care thieves. If one goes to the TRICARE Program Integrity Office web site, one sees a reflection of this inactivity. The most recent Fraud Report is dated 2008 and under ‘‘News,’’ there are two items for 2010 and no items for 2009. The question we hear continually is whether anything is going on except talk about raising fees and copays. As an example, NAUS is informed that the Department of Defense Inspector Gen- eral reported fraud problems in the Philippines as long ago as 1998. Yet fraudulent payments continued for 7 years, untended, merely observed, until finally, more than a year ago, action was taken to curb the problem and order a Philippine corporation to pay back more than $100 million in fraudulent payments. Our members tire of hearing they should pay more when they hear stories about or see little evidence of our government doing anything but sitting on its hands, often taking little to no action for years on this type of criminal activity. NAUS urges the Subcommittee to challenge DOD and TRICARE authorities to put some guts behind efforts to drive fraud down and out of the system. If left unchecked, fraud will increasingly strip away resources from government programs like TRICARE. And unless Congress directs the Administration to take action, we all know who will be left holding the bag—the law-abiding retiree and family. We urge the Subcommittee to take the actions necessary for honoring our obligation to those men and women who have worn the nation’s military uniform. Root out the corruption, fraud and waste. And confirm America’s solemn, moral obligation to support our troops, our military retirees, and their families. They have kept their promise to our Nation, now it’s time for us to keep our promise to them. 529

Military Quality of Life: Pay For fiscal year 2011, the Administration recommends a 1.4 percent across-the- board pay increase for members of the Armed Forces. The proposal is designed, according to the Pentagon, to keep military pay in line with civilian wage growth. The National Association for Uniformed Services calls on Members of Congress to put our troops and their families first. Our forces are stretched thin, at war, yet getting the job done. We ask you to express the nation’s gratitude for their critical service, increase basic pay and drill pay one-half percent above the administration’s request to 1.9 percent. Congress and the administration have done a good job over the recent past to narrow the gap between civilian-sector and military pay. The differential, which was as great as 14 percent in the late 1990s, has been reduced to just under 3 percent with the January 2010 pay increase. The National Association for Uniformed Services applauds you, Mr. Chairman, for the strides you have made, and we encourage you to continue your efforts to ensure DOD manpower policy maintains a compensation package that is reasonable and competitive. We also encourage your review of providing bonus incentives to entice individuals with certain needed skills into special jobs that help supply our manpower for critical assets. These packages can also attract ‘‘old hands’’ to come back into the game with their skills. The National Association for Uniformed Services asks you to do all you can to fully compensate these brave men and women for being in harm’s way, we should clearly recognize the risks they face and make every effort to appropriately compensate them for the job they do. Military Quality of Life: Family Housing Accounts The National Association for Uniformed Services urges the Subcommittee to provide adequate funding for military construction and family housing accounts used by DOD to provide our service members and their families quality housing. The funds for base allowance and housing should ensure that those serving our country are able to afford to live in quality housing whether on or off the base. The current program to upgrade military housing by privatizing Defense housing stock is working well. We encourage continued oversight in this area to ensure joint military-de- veloper activity continues to improve housing options. Clearly, we need to be particularly alert to this challenge as we implement BRAC and related rebasing changes. The National Association for Uniformed Services also asks special provision be granted the National Guard and Reserve for planning and design in the upgrade of facilities. Since the terrorist attacks of Sept. 11, 2001, our Guardsmen and reservists have witnessed an upward spiral in the rate of deployment and mobilization. The mission has clearly changed, and we must recognize that Reserve Component Forces account for an increasing role in our national defense and homeland security responsibilities. The challenge to help them keep pace is an obligation we owe for their vital service. Increase Force Readiness Funds The readiness of our forces is in decline. The long war fought by an overstretched force tells us one thing: there are simply too many missions and too few troops. Ex- tended and repeated deployments are taking a human toll. Back-to-back deployments means, in practical terms, that our troops face unrealistic demands. To sustain the service we must recognize that an increase in troop strength is needed and it must be resourced. In addition, we ask you to give priority to funding for the operations and maintenance accounts where money is secured to reset, recapitalize and renew the force. The National Guard, for example, has virtually depleted its equipment inventory, causing rising concern about its capacity to respond to disasters at home or to train for its missions abroad. The deficiencies in the equipment available for the National Guard to respond to such disasters include sufficient levels of trucks, tractors, communication, and mis- cellaneous equipment. If we have another overwhelming storm, hurricane or, God forbid, a large-scale terrorist attack, our National Guard is not going to have the basic level of resources to do the job right. Walter Reed Army Medical Center Another matter of great interest to our members is the plan to realign and consolidate military health facilities in the National Capital Region. The proposed plan includes the realignment of all highly specialized and sophisticated medical services 530 currently located at Walter Reed Army Medical Center in Washington, DC, to the National Naval Medical Center in Bethesda, MD, and the closing of the existing Walter Reed by 2011. While we herald the renewed review of the adequacy of our hospital facilities and the care and treatment of our wounded warriors that result from last year’s news reports of deteriorating conditions at Walter Reed Army Medical Center, the Na- tional Association for Uniformed Services believes that Congress must continue to provide adequate resources for WRAMC to maintain its base operations’ support and medical services that are required for uninterrupted care of our catastrophically wounded soldiers and marines as they move through this premier medical center. We request that funds be in place to ensure that Walter Reed remains open, fully operational and fully functional, until the planned facilities at Bethesda or Fort Belvoir are in place and ready to give appropriate care and treatment to the men and women wounded in armed service. Our wounded warriors deserve our nation’s best, most compassionate healthcare and quality treatment system. They earned it the hard way. And with application of the proper resources, we know the nation will continue to hold the well being of soldiers and their families as our number one priority. Department of Defense, Seamless Transition Between the DOD and VA The development of electronic medical records remains a major goal. It is our view that providing a seamless transition for recently discharged military is especially important for servicemembers leaving the military for medical reasons related to combat, particularly for the most severely injured patients. The National Association for Uniformed Services is pleased to receive the support of President Obama and the forward movement of Secretaries Gates and Shinseki toward this long-supported goal of providing a comprehensive e-health record. The National Association for Uniformed Services calls on the Appropriations Com- mittee to continue the push for DOD and VA to follow through on establishing a bi-directional, interoperable electronic medical record. Since 1982, these two departments have been working on sharing critical medical records, yet to date neither has effectively come together in coordination with the other. Taking care of soldiers, sailors, airmen and marines is a national obligation, and doing it right sends a strong signal to those currently in military service as well as to those thinking about joining the military. DOD must be directed to adopt electronic architecture including software, data standards and data repositories that are compatible with the system used at the De- partment of Veterans Affairs. It makes absolute sense and it would lower costs for both organizations. If our seriously wounded troops are to receive the care they deserve, the departments must do what is necessary to establish a system that allows seamless transition of medical records. It is essential if our nation is to ensure that all troops receive timely, quality healthcare and other benefits earned in military service. To improve the DOD/VA exchange, the transfer should include a detailed history of care provided and an assessment of what each patient may require in the future, including mental health services. No veteran leaving military service should fall through the bureaucratic cracks. Defense Department Force Protection The National Association for Uniformed Services urges the Subcommittee to provide adequate funding to rapidly deploy and acquire the full range of force protection capabilities for deployed forces. This would include resources for up-armored high mobility multipurpose wheeled vehicles and add-on ballistic protection to provide force protection for soldiers in Iraq and Afghanistan, ensure increased activity for joint research and treatment effort to treat combat blast injuries resulting from improvised explosive devices (IEDs), rocket propelled grenades, and other attacks; and facilitate the early deployment of new technology, equipment, and tactics to counter the threat of IEDs. We ask special consideration be given to counter IEDs, defined as makeshift or ‘‘homemade’’ bombs, often used by enemy forces to destroy military convoys and currently the leading cause of casualties to troops deployed in Iraq. These devices are the weapon of choice and, unfortunately, a very effective weapon used by our enemy. The Joint Improvised Explosive Device Defeat Organization (JIEDDO) is established to coordinate efforts that would help eliminate the threat posed by these IEDs. We urge efforts to advance investment in technology to counteract radio-controlled devices used to detonate these killers. Maintaining support is required to stay ahead of our enemy and to decrease casualties caused by IEDs. 531

Defense Health Program—TRICARE Reserve Select Mr. Chairman, another area that requires attention is reservist participation in TRICARE. As we are all aware, National Guard and Reserve personnel have seen an upward spiral of mobilization and deployment since the terrorist attacks of Sept. 11, 2001. The mission has changed and with it our reliance on these forces has risen. Congress has recognized these changes and begun to update and upgrade protections and benefits for those called away from family, home and employment to active duty. We urge your commitment to these troops to ensure that the long overdue changes made in the provision of their heath care and related benefits is adequately resourced. We are one force, all bearing a critical share of the load. Department of Defense, Prosthetic Research Clearly, care for our troops with limb loss is a matter of national concern. The global war on terrorism in Iraq and Afghanistan has produced wounded soldiers with multiple amputations and limb loss who in previous conflicts would have died from their injuries. Improved body armor and better advances in battlefield medicine reduce the number of fatalities, however injured soldiers are coming back often- times with severe, devastating physical losses. In order to help meet the challenge, Defense Department research must be adequately funded to continue its critical focus on treatment of troops surviving this war with grievous injuries. The research program also requires funding for continued development of advanced prosthesis that will focus on the use of prosthetics with microprocessors that will perform more like the natural limb. The National Association for Uniformed Services encourages the Subcommittee to ensure that funding for Defense Department’s prosthetic research is adequate to support the full range of programs needed to meet current and future health challenges facing wounded veterans. To meet the situation, the Subcommittee needs to focus a substantial, dedicated funding stream on Defense Department research to address the care needs of a growing number of casualties who require specialized treatment and rehabilitation that result from their armed service. We would also like to see better coordination between the Department of Defense Advanced Research Projects Agency and the Department of Veterans Affairs in the development of prosthetics that are readily adaptable to aid amputees. Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) The National Association for Uniformed Services supports a higher priority on De- fense Department care of troops demonstrating symptoms of mental health disorders and traumatic brain injury. It is said that Traumatic Brain Injury (TBI) is the signature injury of the Iraq war. Blast injuries often cause permanent damage to brain tissue. Veterans with severe TBI will require extensive rehabilitation and medical and clinical support, including neurological and psychiatric services with physical and psycho-social therapies. We call on the Subcommittee to fund a full spectrum of TBI care and to recognize that care is also needed for patients suffering from mild to moderate brain injuries, as well. The approach to this problem requires resources for hiring caseworkers, doctors, nurses, clinicians and general caregivers if we are to meet the needs of these men and women and their families. The mental condition known as Post Traumatic Stress Disorder (PTSD) has been well known for over 100 years under an assortment of different names. For example more than 60 years ago, Army psychiatrists reported, ‘‘That each moment of combat imposes a strain so great that...psychiatric casualties are as inevitable as gunshot and shrapnel wounds in warfare.’’ PTSD is a serious psychiatric disorder. While the government has demonstrated over the past several years a higher level of attention to those military personnel who exhibit PTSD symptoms, more should be done to assist service members found to be at risk. Pre-deployment and post-deployment medicine is very important. Our legacy of the Gulf War demonstrates the concept that we need to understand the health of our service members as a continuum, from pre- to post-deployment. The National Association for Uniformed Services applauds the extent of help provided by the Defense Department, however, we encourage that more resources be made available to assist. Early recognition of the symptoms and proactive programs are essential to help many of those who must deal with the debilitating effects of mental injuries, as inevitable in combat as gunshot and shrapnel wounds. We encourage the Members of the Subcommittee to provide these funds, to closely monitor their expenditure and to see they are not redirected to other areas of defense spending. 532

Armed Forces Retirement Home The National Association for Uniformed Services is pleased to note the Sub- committee’s continued interest in providing funds for the Armed Forces Retirement Home (AFRH). We urge the Subcommittee to meet the challenge in providing adequate funding for the facility in Washington, DC, and Gulfport, Mississippi. And we thank the Subcommittee for the provision of funding that has led to the reconstruction of the Armed Forces Retirement Home in Gulfport, destroyed in 2005 as a result of Hurricane Katrina. And we look forward to the opening of the home scheduled for October 2010. NAUS is informed that when completed (the construction is 96 percent done, May 2010), the facility will provide independent living, assisted living and long-term care to more than 500 residents. The National Association for Uniformed Services also applauds the recognition of the Washington AFRH as a historic national treasure. And we look forward to working with the Subcommittee to continue providing a residence for and quality-of-life enhancements to these deserving veterans. We ask that continued care and attention be given to the mixed-use development to the property’s southern end, as approved. The AFRH home is a historic national treasure, and we thank Congress for its oversight of this gentle program and its work to provide for a world-class care for military retirees. Improved Medicine with Less Cost at Military Treatment Facilities The National Association for Uniformed Services is also seriously concerned over the consistent push to have Military Health System beneficiaries age of 65 and over moved into the civilian sector from military care. That is a very serious problem for the Graduate Medical Education (GME) programs in the MHS; the patients over 65 are required for sound GME programs, which, in turn, ensure that the military can retain the appropriate number of physicians who are board certified in their specialties. TRICARE/HA policies are pushing these patients out of military facilities and into the private sector where the cost per patient is at least twice as expensive as that provided within Military Treatment Facilities (MTFs). We understand that there are many retirees and their families who must use the private sector due to the distance from the closest MTF; however, where possible, it is best for the patients themselves, GME, medical readiness, and the minimizing the cost of TRICARE premiums if as many non-active duty beneficiaries are taken care of within the MTFs. As more and more MHS beneficiaries are pushed into the private sector, the cost of the MHS rises. The MHS can provide better medicine, more appreciated service and do it at improved medical readiness and less cost to the taxpayers. Uniformed Services University of the Health Sciences As you know, the Uniformed Services University of the Health Sciences (USUHS) is the nation’s Federal school of medicine and graduate school of nursing. The medical students are all active-duty uniformed officers in the Army, Navy, Air Force and U.S. Public Health Service who are being educated to deal with wartime casualties, national disasters, emerging diseases and other public health emergencies. The National Association for Uniformed Services supports the USUHS and requests adequate funding be provided to ensure continued accredited training, especially in the area of chemical, biological, radiological and nuclear response. In this regard, it is our understanding that USUHS requires funding for training and educational focus on biological threats and incidents for military, civilian, uniformed first responders and healthcare providers across the nation. Joint POW/MIA Accounting Command (JPAC) We also want the fullest accounting of our missing servicemen and ask for your support in DOD dedicated efforts to find and identify remains. It is a duty we owe to the families of those still missing as well as to those who served or who currently serve. NAUS supports the fullest possible accounting of our missing servicemen. It is a duty we owe the families, to ensure that those who wear our country’s uniform are never abandoned. We request that appropriate funds be provided to support the JPAC mission for fiscal year 2011. Appreciation for the Opportunity to Testify As a staunch advocate for our uniformed service men and women, The National Association for Uniformed Services recognizes that these brave men and women did not fail us in their service to country, and we, in turn, must not fail them in providing the benefits and services they earned through honorable military service. 533

Mr. Chairman, The National Association for Uniformed Services appreciates the Subcommittee’s hard work. We ask that you continue to work in good faith to put the dollars where they are most needed: in strengthening our national defense, ensuring troop protection, compensating those who serve, providing for DOD medical services including TRICARE, and building adequate housing for military troops and their families, and in the related defense matters discussed today. These are some of our nation’s highest priority needs and we ask that they be given the level of attention they deserve. The National Association for Uniformed Services is confident you will take special care of our nation’s greatest assets: the men and women who serve and have served in uniform. We are proud of the service they give to America every day. They are vital to our defense and national security. The price we pay as a nation for their earned benefits is a continuing cost of war, and it will never cost more nor equal the value of their service. Again, the National Association for Uniformed Services deeply appreciates the opportunity to present the Association’s views on the issues before the Defense Appro- priations Subcommittee. Chairman INOUYE. Next witness, Ms. Elizabeth Cochran. Ms. Cochran.

STATEMENT OF ELIZABETH COCHRAN, SECRETARY, ASSOCIATIONS FOR AMERICA’S DEFENSE Ms. COCHRAN. Thank you, Mr. Chairman. Mr. Chairman and Mr. Vice Chairman of the subcommittee, the Associations for America’s Defense is very grateful to testify today. We would like to thank the subcommittee for its stewardship on defense issues and setting an example of your nonpartisan leadership. The Associations for America’s Defense is concerned that U.S. defense policy is sacrificing future security for near-term readiness. Most concerning is the vigorous pursuit to cut existing programs. Admiral Mike Mullen stated during his testimony before the House Armed Services Committee in February that as fiscal pressures increase, our ability to build future weapons systems will be impacted by decreasing modernization budgets, as well as mergers and acquisitions. A4AD is in agreement, and we are alarmed about the fiscal year 2011 unfunded program list submitted by the services, which continues on fiscal year 2010’s list, which was 87 percent lower than 2009’s. We are more concerned that unfunded requests continue to be driven by budgetary factors more than risk assessment, which will impact national security. Additionally, the result of such budgetary policy could again lead to a hollow force whose readiness and effectiveness has been subsequently degraded, and lessened efficiency may not be immediately evident. We support increasing defense spending to 5 percent of the Gross Domestic Product during times of war to cover procurement and prevent unnecessary personnel end strength cuts. According to the Office of Management and Budget, base defense spending will stay relatively flat for the next 5 years. We disagree with placing such constraints on defense because it could lead to readiness and effectiveness being degraded. As always, our military will do everything possible to accomplish its missions, but response time is measured by equipment readiness. Last year, due to DOD’s tactical aircraft acquisition programs being blunted by cost and schedule overruns, the Air Force offered to retire 250 fighter jets, which the Secretary of Defense accepted. 534 Until new systems are acquired in sufficient quantities to replace legacy fleets, these legacy systems must be sustained. As the military continues to become more expeditionary, more airlift C–17 and C–130Js will be required. Yet DOD has decided to shut down production of C–17s. Procurement needs to be accelerated, modernized, and mobility requirements need to be reported upon. The need for air refueling is utilized worldwide in DOD operations, but significant numbers of tankers are old and plagued with structural problems. The Air Force would like to retire as many as 131 of the Eisenhower-era KC–135E tankers by the end of the decade. These aircraft must be replaced. We also thank this subcommittee to continue to provide its appropriations for the National Guard and Reserve equipment requirements. The National Guard’s goal is to make at least one-half the Army and Air’s assets available to Governors and adjunct generals at any given time. Appropriating funds for the Guard and Re- serve equipment provides Reserve chiefs and Guard directors with flexibility of prioritizing funding. Earlier this month, a sustainable defense task force released the report ‘‘Debt, Deficits, and Defense: A Way Forward.’’ We are dis- tressed that it recommends cutting up to $443 billion for conventional forces, canceling several programs including the MV–22 Os- prey, the expeditionary fighting vehicle, Air Force and Marine Corps F–35, reducing the size of the Navy to 230 ships, 8 air wings, and cutting up to 200,000 military personnel. Another very worrisome aspect is the recommendation to revert the Reserve components back to a strategic reserve strictly. Na- tional security demands both an operational and a strategic reserve. When at war, there is an outstanding threat, and it is not time for a peace dividend. A4AD members are very concerned about planned cuts as proposed by DOD and this task force. We generally appreciate the support of the subcommittee, particularly at a time when there is growing pressure from other members to cut further programs. Once again, we thank you for your ongoing support of the Na- tion, the armed forces, and our fine men and women serving this Nation. Please contact us with any questions. Thank you. Chairman INOUYE. I thank you very much, Ms. Cochran. An association of this nature, we would expect that a four-star general testify. But you have done a good job. Thank you. Senator COCHRAN. Thank you very much for looking carefully at all aspects of the budget requests submitted by the administration. I think your testimony will be very helpful to the subcommittee as we continue our deliberations. [The statement follows:]

PREPARED STATEMENT OF ELIZABETH COCHRAN

ASSOCIATIONS FOR AMERICA’S DEFENSE Founded in January of 2002, the Association for America’s Defense (A4AD) is an adhoc group of Military and Veteran Associations that have concerns about National Security issues that are not normally addressed by The Military Coalition (TMC) 535 and the National Military Veterans Alliance (NMVA), but participants are members from each. Members have developed expertise in the various branches of the Armed Forces and provide input on force policy and structure. Among the issues that are addressed are equipment, end strength, force structure, and defense policy. A4AD, also, cooperatively works with other associations, who provide input while not including their association name to the membership roster. Participating Associations: Air Force Association; Army and Navy Union; Associa- tion of the U.S. Navy; Enlisted Assoc. of the National Guard of the U.S.; Marine Corps Reserve Association; Military Order of World Wars; National Assoc. for Uni- formed Services; Naval Enlisted Reserve Association; Reserve Enlisted Association; Reserve Officers Association; The Flag and General Officers’ Network; and The Re- tired Enlisted Association.

INTRODUCTION Mister Chairman and distinguished members of the committee, the Associations for America’s Defense (A4AD) is again very grateful for the invitation to testify before you about our views and suggestions concerning current and future issues facing the defense appropriations. The Association for America’s Defense is an adhoc group of twelve military and veteran associations that have concerns about national security issues. Collectively, we represent armed forces members and their families, who are serving our nation, or who have done so in the past.

CURRENT VERSUS FUTURE: ISSUES FACING DEFENSE The Associations for America’s Defense would like to thank this subcommittee for the ongoing stewardship that it has demonstrated on issues of defense. While in a time of war, this subcommittee’s pro-defense and non-partisan leadership continues to set an example. Force Structure: Erosion in Capability The Obama Administration’s 2010 Quadrennial Defense Review (QDR) advances two objectives: further rebalance the Armed Force’s capabilities to prevail in today’s wars while building needed capabilities to deal with future threats; and second, reform the Department of Defense’s (DOD) institutions and processes to better support warfighters’ urgent needs; purchase weapons that are usable, affordable, and needed; and ensure that taxpayer dollars are spent wisely and responsibly. The new QDR calls for DOD to continually evolve and adapt in response to the changing security environment. During his testimony before the House Armed Services Committee (HASC) in Feb- ruary, Admiral Mike Mullen stated, ‘‘...I am growing concerned about our defense industrial base, particularly in ship building and space. As fiscal pressures increase, our ability to build future weapon systems will be impacted by decreasing modernization budgets as well as mergers and acquisitions.’’ In 2009 Secretary of Defense Robert Gates testified before the Senate Armed Services Committee (SASC) that the United States should focus on the wars that we are fighting today, not on future wars that may never occur. He also asserts that U.S. conventional capabilities will remain superior for another 15 years. Anthony Cordesman, a national security expert for the Center for Strategic and International Studies, says that Gates’ plan should be viewed as a set of short-term fixes aimed at helping ‘‘a serious cost containment problem,’’ not a new national security policy. War planners are often accused of planning for the last war. Secretary Gates speaks to enhancing the capabilities of fighting today’s wars. A concern arises on whether DOD’s focus should be on irregular or conventional warfare, and whether it should be preparing for a full scale ‘‘peer’’ war. Hollow Force A4AD could not disagree more by placing such budgetary constraints on defense. Member associations question the spending priorities of the current administration. ‘‘Fiscal restraint for defense and fiscal largesse for everything else,’’ commented then ranking member John McHugh at a HASC hearing on the defense budget in May 2009. The result of such a budgetary policy could again lead to a hollow force whose readiness and effectiveness has been subtly degraded and lessened efficiency will not be immediately evident. This process which echoes of the past, raises no red flags and sounds no alarms, and the damage can go unnoticed and unremedied until a crisis arises highlighting how much readiness decayed. 536

Emergent Risks Members of this group are concerned that U.S. defense policy is sacrificing future security for near term readiness. Our efforts are so focused to provide security and stabilization in Afghanistan and withdrawing from Iraq, that risk is being accepted as an element of future force planning. Force planning is being driven by current overseas contingency operations, and increasingly on budget limitations. Careful study is needed to make the right choice. A4AD is pleased that Congress and this subcommittee continue oversight in these decisions. What seems to be overlooked is that the United States is involved in a Cold War as well as a Hot War with two theaters as well as varying issues in the Middle East, North Korea, China, Russia, and Iran which are growing areas of risk. Korean Peninsula Provocatively, North Korea successfully tested a nuclear weapon at full yield, unilaterally withdrew from that 1953 armistice. The Republic of Korea lost a navy ship sunk to a torpedo. South Korean and U.S. troops have been put on the highest alert level in years. North Korea has 1.2 million troops, with 655,000 South Korean soldiers and 28,500 U.S. troops stationed to the South. While not an immediate danger to the United States, North Korea is viewed as an increased threat to its neighbors, and is potentially a destabilizing factor in Asia. North Korea may be posturing, but it is still a failed state, where misinterpretation clouded by hubris could start a war. The North has prepositioned and could fire up to 250,000 rounds of heavy artillery in the first 48 hours of a war along the border and into Seoul. China China’s armed forces are the largest in the world and have undergone double-digit increases in military spending since the early 90s. DOD has reported that China’s actual spending on its military is up to 250 percent higher than figures reported by the Chinese government, and their cost of materials and labor is much lower. In 2009, China’s defense budget increased by almost 15 percent and further increased about 7.5 percent for 2010. DOD’s 2009 report to Congress on China’s military strength estimated in 2008 that its spending ranged from $105 and $150 billion, the second highest in the world after the United States. It should be noted that these dollars go further within the Chinese economy as well. China’s build-up of sea and air military power appears aimed at the United States, according to Admiral Michael Mullen, the chairman of the Joint Chiefs of Staff. Furthermore China is reluctant to support international efforts in reproaching North Korea, which recently as evidenced by the sunk South Korean naval vessel. The U.S. military strategy cannot be held hostage by international debts. While China is the biggest foreign holder of U.S. Treasuries with $895.2 billion at the end of March, we cannot be lulled into a sense of complacency. Russia While the Obama Administration has been working on a ‘‘reset’’ policy towards Russia, including a new START treaty, there are areas of concern. A distressing issue is their relationship with Iran which the United States and even the United Nations have brought sanctions against. Additionally Russia sells arms to countries like Syria and Venezuela that also have ties to Iran. Prime Minister Vladimir Putin stated recently that, ‘‘Despite the difficult environment in which we are today, we still found a way to not only maintain but also increase the total amount of state defense order.’’ Russia’s defense budget rose by 34 percent in 2009, as reported by the International Institute of Strategic Study in an annual report. Iran While Iran lobs petulant rhetoric towards the United States, the real international tension is between Israel and Iran. Israel views Tehran’s atomic work as a threat, and would consider military action against Iran as it has threatened to ‘‘eliminate Israel.’’ Israeli leadership has warned Iran that any attack on Israel would result in the ‘‘destruction of the Iranian nation.’’ Israel is believed to have between 75 to 200 nuclear warheads with a megaton capacity. Funding for the Future Since Secretary Gates initiated the practice of reviewing all the services’ unfunded requirements lists prior to testifying before Congress the result has been in fiscal restraint. The unfunded lists have shown a dramatic reduction from $33.3 billion for fiscal year 2008 and $31 billion for fiscal year 2009 to $3.8 billion for fiscal year 2010 and $2.6 billion for fiscal year 2011. Most notable is that the Air Force in prior 537 years represented about 50 percent of the total unfunded requirements list and is now proportionate to the other services. In 2009 Secretary Gates told SASC, ‘‘It is simply not reasonable to expect the defense budget to continue increasing at the same rate it has over the last number of years.’’ He went further saying, ‘‘We should be able to secure our nation with a base budget of more than half a trillion dollars.’’ Following through on these statements the Secretary has instituted a plan to save $100 billion over 5 years. Two- thirds of the savings are supposed to come from decreasing overhead and one-third from cuts in weapons systems and force structure, meaning less people. For the 2012 budget, the military services and defense agencies have been asked to find $7 billion in savings. These impending cuts are in addition to weapon systems cuts from last year which amounted to about $300 billion. Despite the great need to manage budgets in light of the financial situation that the United States faces, we are still conducting two theaters in a war, and should be prepared to fight if another threat challenges U.S. National Security. Defense as a Factor of GDP Secretary Gates has warned that each defense budget decision is ‘‘zero sum,’’ providing money for one program will take money away from another. A4AD encourages the appropriations subcommittee on defense to scrutinize the recommended spending amount for defense. Each member association supports increasing defense spending to 5 percent of Gross Domestic Product during times of war to cover procurement and prevent unnecessary personnel end strength cuts. A Changing Manpower Structure The 2010 QDR recommends incremental reductions in force structure shrinking the fleet to about 250 to 260 ships, reducing the number of active Army brigade combat teams to 45 and Air Force tactical fighter wings to 17, while maintaining the 202,100 Marine Corps active manpower level. The Heritage Foundation projects there will be a 5 percent decrease in manpower over the next 5 years. A4AD supports a moratorium on further cuts including the National Guard and other military Reserve. We further suggest that a Zero Based Review (ZBR) be performed to evaluate the current manning requirements. Additionally, as the active force is cut, these manpower and equipment assets should remain in the Reserve Components. Maintaining a Surge Capability The Armed Forces need to provide critical surge capacity for homeland security, domestic and expeditionary support to national security and defense, and response to domestic disasters, both natural and man-made that goes beyond operational forces. A strategic surge construct includes manpower, airlift and air refueling, sealift inventory, logistics, and communications to provide a surge-to-demand operation. This requires funding for training, equipping and maintenance of a mission-ready strategic reserve composed of active and reserve units. An additional requirement is excess infrastructure which would permit the housing of additional forces that are called-up beyond the normal operational force. Dependence on Foreign Partnership Part of the U.S. military strategy is to rely on long-term alliances to augment U.S. forces. As stated in a DOD progress report. ‘‘Our strategy emphasizes the capacities of a broad spectrum of partners...We must also seek to strengthen the resiliency of the international system...helping others to police themselves and their regions.’’ The fiscal year 2011 budget request included an increase from $350 to $500 million for the Global Train and Equip authority that helps build capabilities of key partners. The risk of basing a national security policy on foreign interests and good world citizenship is increasingly uncertain because the United States does not necessarily control our foreign partners as their national objectives can differ from our own. Al- liances should be viewed as a tool and a force multiplier, but not the foundation of National Security.

UNFUNDED REQUIREMENTS The fiscal year 2011 Unfunded Program Lists submitted by the military services to Congress continued in fiscal year 2010’s steps, which was 87 percent less than was requested for fiscal year 2009. A4AD has concerns that the unfunded requests continue to be driven more by budgetary factors than risk assessment which will 538 impact national security. The following are lists submitted by A4AD including additional non-funded recommendations. Tactical Aircraft DOD’s efforts to recapitalize and modernize its tactical air forces have been blunted by cost and schedule overruns in its new tactical aircraft acquisition programs. For fiscal year 2010 the Air Force offered a plan to retire 250 fighter jets in one year alone, which Secretary Gates accepted. Yet the HASC observed after approving Navy and Marine Corps procurement, and research and development programs in May, that it’s concerned about the unacceptable deficit of approximately 250 tactical aircraft by 2017, warning future budget requests must address this. Until new systems are acquired in sufficient quantities to replace legacy fleets, legacy systems must be sustained and kept operationally relevant. The risk of the older aircraft and their crews and support personnel being eliminated before the new aircraft are on line could result in a significant security shortfall. Airlift Hundreds of thousands of hours have been flown, and millions of passengers and tons of cargo have been airlifted. Their contributions in moving cargo and passengers are absolutely indispensable to American warfighters in overseas contingencies. Both Air Force and Naval airframes and air crew are being stressed by these lift missions. As the military continues to become more expeditionary it will require more airlift. Procurement needs to be accelerated and modernized, and mobility requirements need to be reported upon. While DOD has decided to shut down production of C–17s, existing C–17s are being worn out at a higher rate than anticipated. Congress should independently examine actual airlift needs, and plan for C–17 modernization, a possible follow-on procurement. Given the C–5’s advanced age, it makes more sense to retire the oldest and most worn of these planes and use the upgrade funds to buy more C–5s and modernize current C–5 aircraft. DOD should also continue with a joint multi-year procurement of C–130Js. The Navy and Marine Corps need C–40A replacements for the C–9B aircraft; only nine C–40s have been ordered since 1997 to replace 29 C–9Bs. The Navy requires Navy Unique Fleet Essential Airlift. The C–40A, a derivative of the 737–700C a Federal Aviation Administration (FAA) certified, while the aging C–9 fleet is not compliant with either future global navigation requirements or noise abatement standards that restrict flights into European airfields. The Air Force-Navy-Marine Corps fighter inventory will decline steadily from 3,264 airframes in fiscal year 2011 to 2,883 in fiscal year 2018, at which point the air fleet is supposed to have a slow increase. Tankers The need for air refueling is reconfirmed on a daily basis in worldwide DOD operations. A significant number of tankers are old and plagued with structural problems. The Air Force would like to retire as many as 131 of the Eisenhower-era KC– 135E tankers by the end of the decade. DOD and Congress must work together to replace of these aircraft. A contract needs to be offered. A4AD thanks this committee for its ongoing support to resolve this issue. NGREA A4AD asks this committee to continue to provide appropriations for unfunded Na- tional Guard and Reserve Equipment Requirements. The National Guard’s goal is to make at least half of Army and Air assets (personnel and equipment) available to the Governors and Adjutants General at any given time. To appropriate funds to Guard and Reserve equipment provides Reserve Chiefs with a flexibility of prioritizing funding. UNFUNDED EQUIPMENT REQUIREMENTS [The services and lists are not in priority order.]

Amounts in millions

Air Force: C–130 Aircraft Armor (79) ...... $15.8 C–130 NVIS Windows (64) ...... 1 C–130 Crash Resistant Loadmaster Seat Modifications (76) ...... 19 539

UNFUNDED EQUIPMENT REQUIREMENTS—Continued [The services and lists are not in priority order.]

Amounts in millions

C–17 Armor Refurbishment and Replacement (17) ...... 2 Air Force Submitted Requirements: Weapons System Sustainment: Programmed Depot Maintenance (PDMs), High Velocity Maintenance (HVM), Service Life Extension Program (SLEP)/Scheduled Structural Inspections (SSI), and engine overhauls [ANG & AFR included] ...... 337.2 Theater Posture: contract maintenance of Base Expeditionary Airfield Resources (BEAR)/War Readiness Material assets; procure Fuels Operational Readiness Capability equipment (FORCE) sets, fuel blad- ders/liners ...... 70 DCGS Integrated C3 PED System ...... 55 Battlefield Airmen Equipment/JTAC Modeling & Simulation ...... 28 .7 Vehicle & Support Equipment Procurement ...... 57.1 Air Force Reserve (USAFR): LITENING Targeting pod (19) ...... 24 C–130 Secure Line of Sight/Beynold Line of Sight (SLOS/BLOS) (63) ...... 22 .1 AFRC ATP Procurement & Spiral Upgrade (54) ...... 54 C–130 Aircraft Armor (79) ...... 15.8 C–130 Crash Resistant Loadmaster Seats (76) ...... 19 F–16 All WX A–G Precision Self-Targeting Capability (54) ...... 120 A–10 On Board Oxygen Generating System (OBOGS) (54) ...... 11 .1 Air National Guard (USANG): F–15 Digital Video Recorder (DVR) (upgrades to ANG F–15 aircraft) ...... 7 C–37B (Gulf Stream) aircraft (4) ...... 256 USANG requires at Andrews AFB to replace the aging C–38A fleet C–17 (5 minimum) ...... 1,000 Requirement identified by NGAUS, EANGUS, AGAUS, and ROA: Security Forces Tactical Vehicles: HMMWVs (1,700) ...... 170 LTMVs (500) ...... 100 Upgraded Personal Protective Equipment: IOTVs (4,600) ...... 3.1 ESAPI Plates (9,200) ...... 7 .5 Concealable Body Armor (8,800) ...... 4.4 Air Refueling Tanker replacements ...... ( 1 ) Army Submitted Requirements: Line of Communication Bridge (LOCB) ...... 15 Light Weight Counter-Mortar Radar (LCMR) ...... 47 .1 NAVSTAR GPS: Defense Advanced GPS Receiver (DAGR) ...... 51 .2 Civil Affairs/Psychological Operations (CA/Psy Ops) ...... 55 Advanced Field Artillery Tactical Data System (AFATDS) Forward Entry Devices ...... 16 .2 Patriot ...... 133.6 Test 7 Evaluation Instrumentation ...... 17 .7 Army Test Range Infrastructure ...... 22 .9 Army Reserve (USAR): Helicopter, Attack AH–64D (3) ...... 75 .5 MTV 5 Ton Cargo Truck, M108s (448) ...... 57 .4 LMTV 2.5 Ton Cargo Truck, M1079 (23) ...... 3 .7 HMMWVs (humvees), ARMT Carrier, M1025 (1,037) ...... 78 Night Vision Goggles, AN/PVX–7B (7,740) ...... 28 Weapons: Machine Gun, 7.62MM, M240B (3,445) ...... 20 .6 Carbine Rifle, 5.56MM, M4 (6,441) ...... 3.7 Next Generation of Loudspeaker System (NGLS) Manpak, NGLS Vehicle (1,344) ...... 86.7 Army National Guard (USARNG): ATLAS (All Terrain Lifter-Army System and II), Truck Lift ...... 4 .3 Chemical Decontamination (JSTDS–SS, CBPS) ...... 11 Radios, COTS Tactical Radios ...... 10 FMTV (Truck tractor: MTV W/E, Truck Van: Expansible MTV W/E) ...... 507 Joint Assault Bridge (Carrier Bridge Launching: Joint Assault XM1074) ...... 35 Navy Submitted Requirements: Aviation Spares: T/M/S, Fleet aircraft ...... 423 Ship Depot Maintenance: deferred surface ship non-docking availabilities ...... 35 Aviation Depot Maintenance: deferred airframes/engines ...... 74 Navy Reserve (USNR): C–40A Combo cargo/passenger airlift aircraft (5) ...... 75 540

UNFUNDED EQUIPMENT REQUIREMENTS—Continued [The services and lists are not in priority order.]

Amounts in millions

EA–18G, Growler (2) Additional 3 Growlers will be needed in fiscal year 2012 ...... 142.8 Navy Expeditionary Combat Command ...... 20 MPF Utility Boat (3) ...... 3 Marine Corps Submitted Requirements: CH–53 Reliability Improvements ...... 34 Warfighter Equipment: KC–130J, UC–35ER, UC–12W ...... 168 Readiness: M88A2 Improved Recovery Vehicle, Mine Roller System, Assault Breacher Vehicle, Family of Field Medical Equipment ...... 131 Modernization of Child Development Center ...... 18 Marine Forces Reserves (MFR): KC–130J Super Hercules Aircraft tankers (4) ...... 200 Light Armored Vehicles (LAV) ...... 1.5 Training Allowance (T/A) Shortfalls (To provide most up to date Individual Combat & Protective Equip- ment: M4 rifles, Rifle Combat Optic (RCO) scopes, Light weight helmets, Small Arms Protective In- sert (SAPI) plates, Modular Tactical Vests, Flame Resistant) ...... 145 Logistics Vehicle Replacement System Cargo ...... ( 1 ) 1 Unkown. Note: A4AD recommends further investment in the DDG 1000 or a similar concept. This vessel was designed to allow expansion for future systems and technology. Any new construction should permit maximized modernization. Restarting procurement of the DDG 51 (Arleigh Burke) class Aegis destroyers limit the Navy with a 35 year old hull design, which requires 350 people to crew. While higher costs are cited, Con- gress should find ways to reduce shipbuilding, maintenance and manpower cost, rather than constrain technology. Reserve Components (RCs) The National Guard Bureau has stated that the aggregate equipment shortage for the RCs is about $45 billion. Common challenges for the RCs are ensuring that equipment is available for pre-mobilization training, transparency of equipment procurement and distribution, and maintenance. One of USANG’s top issues is modernizing legacy aircraft and other weapon systems for dual missions and combat deployments. USARNG equipment challenges include, but aren’t limited to modernizing both the helicopter and Tactical Wheeled Vehicle (TWV) fleets, and interoperability with the active component. Additionally while the ARNG’s total equipment on hand (EOH) is 77 percent, there’s only 62 percent of the authorized equipment in the continental United States (CONUS) available to governors. The Army expects ARNG’s total EOH will fall to 74 percent during 2010. The USAFR’s primary obstacles are defensive systems funding shortfalls, and modernization of data link and secure communications. The USAR has concerns about the modernization of equipment and maintenance infrastructure to support ARFORGEN, sustainment of equipment to support deploying units and ARFOGEN, and increases in procurement funding. Additionally Lieu- tenant General Jack Stultz, chief of the Army Reserve, stated in testimony before the HASC Readiness subcommittee this spring that the USAR is challenged by ‘‘still being budgeted as a strategic reserve.’’ USNR top equipping challenges are aircraft procurement specifically for C–40A, E/A–18G, P–8, and KC–130J; and equipment for civil engineering, material handling, and communications for OCO-related units. The USMFR is concerned about ensuring deploying members continue to receive up to date individual combat clothing and protective equipment in theater as well as maintaining the right amount of equipment on hand at RC units to train prior to deployment. Active Components In DOD’s new 30-year aircraft investment blueprint it calls for the Air Force to pause for at least 10 years in production of new strategic airlifters and long-range bombers. The plan also slows the process to purchase F–35s causing it to not meet its force level requirements until 2035. The Marine Expeditionary Fighting Vehicle (EFV) will be delayed for another year. The Marine Corps (USMC) face a primary challenge of having been a land force for the last decade. The USMC’s naval character has taken a back seat to fighting a virulent resistance in an extended land campaign, and some core competencies are waning. 541

Family A consistent complaint from military families across the board is the lack of spaces and/or prolonged waiting lists for child care centers. While the military has built up child care systems, it is still an urgent need by many, especially those with special needs. Retiree The fiscal year 2008 early retirement benefit for RC members was passed, but it excluded approximately 600,000 members. This law should be fixed so that RC members’ service counts from post-September 11, 2001 rather than from the bill enactment date in 2008. Health Care As the operational tempo for our service members continues to be high and they persist to endure repeated deployments, it becomes ever more essential to provide efficient and timely health screenings for pre- and post-deployments. Achieving and maintaining individual medical readiness standards throughout a service member’s continuum of service is necessary for the military services and components to meet mission requirements as an operational force. Military Voting Congress legislatively mandated DOD to develop an Internet voting system for military voters, but HASC cut $25 million from DOD’s Federal Voting Assistance Program (FVAP). The House stated it was concerned with the immaturity of the Internet voting system standards being developed by the Elections Assistance Commission, supported by FVAP. Denying DOD the funding could ensure those standards remain immature, and may compel the States to proceed with their own Internet voting systems without Federal voting standards or guidelines in place. As the SASC reported bill supports, the Senate Appropriations Committee should fully fund these important programs. Without these vital funds, military voters will be condemned to continued disenfranchisement, lost voting opportunities, and reliance on State-run systems unsupported by Federal standards or evaluation.

CONCLUSION A4AD is a working group of military and veteran associations looking beyond personnel issues to the broader issues of National Defense. This testimony is an overview, and expanded data on information within this document can be provided upon request. Thank you for your ongoing support of the Nation, the Armed Services, and the fine young men and women who defend our country. Please contact us with any questions. Chairman INOUYE. Our next witness is Dr. Jonathan Berman, secretary-treasurer, American Society of Tropical Medicine and Hy- giene.

STATEMENT OF JONATHAN BERMAN, M.D., Ph.D. COLONEL (RETIRED), UNITED STATES ARMY MEDICAL CORPS, ON BEHALF OF THE AMERICAN SOCIETY OF TROPICAL MEDICINE AND HYGIENE Dr. BERMAN. Thank you, Mr. Chairman. I appreciate this opportunity to testify on behalf of the American Society of Tropical Medicine. I am Dr. Berman, Colonel, Medical Corps, retired from the United States Army. The American Society of Tropical Medicine and Hygiene is the principal professional membership organization in the United States, and actually in the world, for tropical medicine and global health. ASTMH represents physicians, researchers, epidemiologists, other health professionals dedicated to the prevention and control of tropical diseases. Because the military operates in many tropical regions, reducing the risk that tropical diseases present to servicemen and women is often critical to mission success and service personnel morale. Ma- 542 laria and other insect-transmitted diseases, such as leishmaniasis and dengue, are particular examples. Antimalarial drugs have saved countless lives throughout the world, including U.S. troops during World War II, Korea, and Viet- nam. The U.S. military has long taken a primary role in the development of antimalarial drugs and vaccines, and nearly all of the most used antimalarials today were developed at least in part by U.S. military researchers. Over 350 million people are at risk for leishmaniasis in 88 countries, 12 million infected currently, 2 million new infections each year. Leishmaniasis was a particular problem for Operation Iraqi Freedom, as a result of which 700 American service personnel became infected. As it happens, the Washington Post yesterday had a large article on leishmaniasis built around statements from military personnel here in the Washington area. Because of leishmaniasis’s prevalence in Iraq and Southwest Asia in general, DOD has spent large resources on this disease, and DOD personnel are the leaders worldwide in development of new anti-leishmanial drugs. Dengue is the leading cause of illness and death in the tropics and subtropics, as many as 100 million people are infected yearly. Although dengue rarely occurs in the United States, it is endemic in Puerto Rico, and periodic outbreaks occur in Samoa and Guam. The intersection of militarily important diseases and tropical medicine is the reason that 15 percent of ASTMH members are also members of the military. For this reason, we respectfully request that the subcommittee expand funding for DOD’s longstanding and successful efforts to develop new drugs, vaccines, and diagnostics to protect service personnel from malaria and tropical diseases. Specifically, we request that in fiscal year 2011, the subcommittee ensure $70 million to DOD to support its ID research efforts through USAMRIID, WRAIR, and NMRC. Presently, DOD funding for this research is about $47 million. To keep up with biomedical inflation, fiscal year 2011 funding needs to be $60 million, and as said, to fill the gaps that have been created by underfunding, ASTMH urges Congress to fund DOD ID research at $70 million—70—in fiscal year 2011. Thank you very much, Mr. Chairman and vice chairman. Chairman INOUYE. I thank you very much, Doctor. I can assure you that this subcommittee is giving this matter our highest priority. Senator COCHRAN. Mr. Chairman? Chairman INOUYE. Our last panel, and I want to thank the panel very much. Senator COCHRAN. Mr. Chairman, could I put in a word for—— Chairman INOUYE. Yes. Senator COCHRAN [continuing]. The last witness? I notice in my notes here that the University of Mississippi has this Center for Natural Products Research and is doing some work in collaboration with Walter Reed Army Institute finding safe drugs to use against the parasites that cause malaria, which was one of the topics that you touched on. 543 Is progress being made in this program? Are you familiar with that? Dr. BERMAN. Yes, sir, I am. There is work on 8-aminoquinolines as replacement for our present drugs. It is an excellent center and really leads in this total effort. Senator COCHRAN. Thank you. Chairman INOUYE. Thank you very much. [The statement follows:]

PREPARED STATEMENT OF JONATHAN BERMAN The American Society of Tropical Medicine and Hygiene (ASTMH) is the principal professional membership organization in the United States, and in the world, for Tropical Medicine and Global Health. ASTMH represents physicians, researchers, epidemiologists, and other health professionals dedicated to the prevention and control of tropical diseases. We appreciate the opportunity to submit testimony to the Senate Defense Appropriations Subcommittee and I request that our full testimony be submitted for the record. Because the military operates in many tropical regions, reducing the risk that tropical diseases present to servicemen and women is often critical to mission success. Malaria and other insect-transmitted diseases such as leishmaniasis and dengue are particular examples. Antimalarial drugs have saved countless lives throughout the world, including troops serving in tropical regions during WWII, the Korean War, and the Vietnam War. The U.S. military has long taken a primary role in the development of antimalarial drugs, and nearly all of the most used anti-malarials were developed in part by U.S. military researchers. Over 350 million people are at risk of leishmaniasis in 88 countries around the world. 12 million people are currently infected and 2 million new infections occur annually. Leishmaniasis was a particular problem for Operation Iraqi Freedom, as a result of which 700 American service personnel became infected [Weina 2004]. Be- cause of leishmaniasis’ prevalence in Iraq and in Southwest Asia in general, the DOD has spent significant time and resources on this disease and DOD personnel are the leaders in development of new antileishmanial drugs. Dengue is a leading cause of illness and death in the tropics and subtropics. As many as 100 million people are infected yearly. Although dengue rarely occurs in the continental United States, it is endemic in Puerto Rico, and in many popular tourist destinations in Latin America and Southeast Asia; periodic outbreaks occur in Samoa and Guam. The DOD has seen about 28 cases of dengue in soldiers per year. The intersection of militarily-important diseases and Tropical medicine is the reason that 15 percent of ASTMH members are members of the military. For this reason, we respectfully request that the Subcommittee expand funding for the Department of Defense’s longstanding and successful efforts to develop new drugs, vaccines, and diagnostics designed to protect servicemen and women from malaria and tropical diseases. Specifically, we request that in fiscal year 2011, the Subcommittee ensure $70 million to the Department of Defense (DOD) to support its infectious disease research efforts through the Army Medical Research Institute for Infectious Diseases, the Walter Reed Army Institute of Research, and the U.S. Naval Medical Research Center. Presently, DOD funding for this important research is at about $47 million. To keep up with biomedical inflation since 2000, fiscal year 2011 funding must be about $60 million. In order to fill the gaps that have been created by underfunding, ASTMH urges Congress to fund DOD infectious disease research at $70 million in fiscal year 2011. We very much appreciate the Subcommittee’s consideration of our views, and we stand ready to work with Subcommittee members and staff on these and other important tropical disease matters. Chairman INOUYE. And our final panel consists of Dr. George Zitnay, Major General David Bockel, Ms. Joy Simha, and Dr. John Boslego. Welcome to the subcommittee, and may I recognize Dr. George Zitnay. 544

STATEMENT OF GEORGE A. ZITNAY, Ph.D., CO-FOUNDER, DEFENSE AND VETERANS BRAIN INJURY CENTER Dr. ZITNAY. Good morning, Chairman Inouye and Vice Chairman Cochran. It is good to be here. My name is George Zitnay. I am the co-founder of the Defense and Brain Injury Center. And before I retired last year, I have spent over 40 years in the field of brain injury. And I have been involved, obviously, in the work of the Department of Defense since the Vietnam war. I have worked very hard on behalf of the military and for wounded warriors and their families, and I come before you this morning to urge funding for the Defense and Veterans Brain Injury Center at the $40 million level for 2011 and for the new National Intrepid Center of Excellence, $45 million. I am requesting specific line-item status for these agencies, as each is responsible for brain injury care, research, treatment, and training. NICoE, or the National Intrepid Center of Excellence, is having its ribbon-cutting ceremony tomorrow, and I hope that both of you will be able to attend that wonderful ceremony at Bethesda tomorrow. As you well know, the NICoE is a volunteer effort on behalf of Mr. Fisher and many individuals. And we are hopeful that the NICoE will be able to treat some 500 service members each year, and their families, for whom standard treatment for TBI has not worked. And I am hopeful that the NICoE will push the envelope to develop cutting-edge research and rehabilitation for individuals with traumatic brain injury from the mild level of TBI all the way through to coma. TBI continues to be the signature injury in the wars in Iraq and Afghanistan, affecting over 10 percent of all deployed service personnel. Blast-related injuries and extended deployments are contributing to an unprecedented number of warriors suffering from TBI, psychological conditions such as anxiety, depression, PTSD, and suicide. The long-term effects of blast injury are yet unknown, and more research is necessary. Also, we need to really make sure that standard pre-deployment baseline measurement and assessments are being done consistently across the services. In addition, there needs to be a much greater emphasis on connecting injured warriors when they return home to community resources and to provide support and education for family members because they are the first people to recognize the symptoms, particularly of mild TBI and PTSD. Last year when I came before this subcommittee, I talked about those individuals in the vegetative state and the minimally conscious. I am very unhappy to report that we still have not provided the level of care necessary for these young men and women between the ages of 18 and 25. You know that the private sector has really moved ahead in this area. Bob Woodruff is a good example. Look at what ABC was able to do by providing him with the best care possible. There is new technology and new opportunities to wake these individuals up with deep brain stimulation and other types of progress. However, that has not been done. We have still not developed a partnership with universities and those major centers. 545 And I want you to know that the VA has renamed the nursing homes that they operate for these individuals from nursing homes to community living centers. What a nice opportunity, isn’t it? While we know many with severe TBI will not go back to work, I can assure you that they deserve the best. And last year, the late Congressman Jack Murtha brought together in Johnstown a large group of experts in this area and really wanted to have this as one of the things that he was quite interested in. Unfortunately, Mr. Chairman and Vice Chairman Cochran, this has not been done. And as I know, since I live in Johnstown, Mr. Murtha wanted this to be accomplished. He invited all of the people to come together, and I can assure you that a consortium composed of Har- vard, people from MIT, from Cornell Medical Center, from St. Jo- seph’s Hospital, from Rockefeller have all come together, and they know that what can be done to serve these individuals. But even though he brought them together, this has not been done, and it has been over a year. So I urge you to consider funding at the $40 million level for the Defense and Veterans Brain Injury Center and for those individuals who now will be served by the new Intrepid Center at Bethesda. And in closing, what I would like to suggest is that since this continuing war in Afghanistan and Iraq, what we have observed is that more and more individuals come home. They seem normal. But it is not until their family members really recognize that something is going on that they need then to have care. And quite frankly, we need to do a lot more in our communities all across this country, whether it is in Mississippi or Hawaii or wherever it is, to connect up our servicemen and women with the best that is possible in our communities. Thank you very much for all that you have done, and I urge you to support at the $40 million level for DVBIC and for the new NICoE Center of Excellence. Chairman INOUYE. I can assure that we will do exactly that. Dr. ZITNAY. Thank you very much, Mr. Chairman. Senator COCHRAN. Thank you for the insight that you have given us and also for your unselfish service in trying to personally make a difference for a lot of servicemen and women who have been injured. Dr. ZITNAY. Well, I am retired now, and I come before you as a volunteer because I am still most interested in what happens to our young men and women in the military. Thank you very much. [The statement follows:]

PREPARED STATEMENT OF GEORGE A. ZITNAY Dear Chairman Inouye, Ranking Member Cochran and Members of the Senate Appropriations Subcommittee on Defense: Thank you for this opportunity to submit testimony in support of funding brain injury programs and initiatives in the Depart- ment of Defense. I am George A. Zitnay, Ph.D., a neuropsychologist and co-founder of the Defense and Veterans Brain Injury Center (DVBIC). I have over 40 years of experience in the fields of brain injury, psychology and disability, including serving as the Executive Director of the Kennedy Foundation, Assistant Commissioner of Mental Retardation in Massachusetts, Commissioner of Mental Health, Mental Retardation and Corrections for the State of Maine, and a founder and Chair of the International Brain Injury Association and the National Brain Injury Research, Treatment and Training Foundation. I have served on the 546

Advisory Committees to the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), was an Expert Advisor on Trauma to the Director General of the World Health Organization (WHO) and served as Chair of the WHO Neurotrauma Committee. In 1992, as President of the national Brain Injury Association, I worked with Con- gress and the Administration to establish what was then called the Defense and Veterans Head Injury Program (DVHIP) after the Gulf War as there was no brain injury program at the time. I have since worn many hats, and helped build the civilian partners to DVBIC: Virginia NeuroCare, Laurel Highlands, and DVBIC-Johns- town. Last year I retired as an advisor to the Department of Defense (DOD) regarding policies to improve the care and rehabilitation of wounded warriors sustaining brain injury. I am pleased that DVBIC continues to be the primary leader in DOD for all brain injury issues. DVBIC has come to define optimal care for military personnel and veterans with brain injuries. Their motto is ‘‘to learn as we treat.’’ The DVBIC has been proactive since its inception, and what began as a small research program, the DVBIC now has 19 sites,1 and serves as the key operational component for brain injury of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) under DOD Health Affairs. I am here today to ask for your support for $40 million for the DVBIC and $45 million for the National Intrepid Center of Excellence (NICoE) in the Defense Ap- propriations bill for fiscal year 2011. This level of funding is consistent with the request made by 30 Members of the Congressional Brain Injury Task Force to the House Appropriations Committee as well as with the President’s budget request. The Administration requested a total of $920 million: $670 million for treatment and $250 million for research. Since DVBIC and NICoE provide both treatment and research, line items are requested for these individual agencies. As you know, traumatic brain injury (TBI) remains the ‘‘signature injury’’ of the conflicts in Iraq and Afghanistan, affecting over 10 percent of all deployed service personnel. Blast-related injuries from improvised explosive devices and extended deployments are contributing to an unprecedented number of TBIs (ranging from mild, as in concussion, to severe, as in unresponsive states of consciousness) and psychological conditions such as anxiety, depression, post traumatic stress disorder (PTSD) and suicide. TBI-related health issues cost billions of dollars, not including lost productivity or diminished quality of life. For a myriad of reasons, it is in everyone’s best interest—our wounded warriors, their families and loved ones, our national security and military readiness and the nation’s taxpayers—to assure that service members with TBI are given the appropriate treatment and rehabilitation as soon as possible. Our country cannot afford to allow service members to fall through the cracks and suffer from the deleterious effects, sometimes life long, of TBI. After sustaining an initial TBI, a service member is at twice the risk of sustaining another TBI and compounding the injury. This can be particularly devastating in a combat zone especially if not removed from action. A 2009 Consensus group of brain injury specialists (50 civilian and military experts), suggested that troops with mild TBI receive cognitive rehabilitation as soon as possible. (Neurorehabilitation. 2010 Jan 1; 26 (3): 239–55. On June 7, 2010, National Public Radio and Propublica published the results of an independent investigation which showed that despite the DOD’s efforts to detect and treat TBI, a huge number remain undiagnosed. NPR reports that ‘‘the nation’s most senior medical officers are attempting to downplay the seriousness of so-called mild TBI. As a result, soldiers haven’t been getting treatment.’’ (http:// www.propublica.org/feature/brain-injuries-remain-undiagnosed-in-thousands-of-soldiers). The report states that ‘‘tens of thousands of troops with TBI have gone un- counted.’’ Consistent Screening is Needed Four years ago, DVBIC began a comparative study on the efficacy of 6 diagnostic screening tools but for various reasons there has been delay in publishing the re-

1 Walter Reed Army Medical Center, Washington, DC; Landstuhl Regional Medical Center, Germany; National Naval Medical Center, Bethesda, MD; James A. Haley Veterans Hospital, Tampa, FL; Naval Medical Center San Diego, San Diego, CA; Camp Pendleton, San Diego, CA; Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Fort Bragg, NC; Fort Carson, CO; Fort Hood, TX; Camp Lejeune, NC; Fort Campbell, Kentucky; Boston VA, Massachusetts; Virginia Neurocare, Inc., Charlottesville, VA; Hunter McGuire Veterans Affairs Medical Center, Richmond, VA; Wilford Hall Medical Center, Lackland Air Force Base, TX; Brooks Army Medical Center, San Antonio, TX; Laurel Highlands, Johnstown, PA; DVBIC-Johnstown, PA. 547 sults. Since May 2008, a pre-deployment cognitive test is used based on DVBIC’s ANAM, but post deployment has been inconsistent. It is my understanding that top DOD officials fear that greater screening may produce false positives and follow up assessments and treatment will be expensive. This is unacceptable. In cases of positive screenings or when there is suspicion of TBI, a neuropsychological battery should be performed. Pending the results of DVBIC’s study, DOD should convene a panel of outside experts to reach a consensus on the best post deployment screening tool which has demonstrated efficacy and use it consistently across the board. Amendments have been offered to the DOD Authorization bill currently under consideration that would help achieve this. Brigadier General Loree Sutton, head of the Defense Centers of Excellence for Psychological Health and TBI has repeatedly stated that her goal is to have ‘‘consistent standards of excellence across the board.’’ This is an area that desperately needs consistency. Long Term Effects of Blast Injury Remain Unknown The lnstitute of Medicine’s (IOM) Preliminary Assessment on the Readjustment Needs of Veterans, Service Members and Their Families (March 31, 2010) notes that there is a paucity of information on the lifetime needs of persons with TBI in the military and civilian sectors and recommends funding for additional research into protocols to manage the lifetime effects of TBI. This issue is compounded by the fact that blast injuries from IEDs are quite different from TBIs sustained in the civilian sector, from sports and car crashes. There is even less information on the long term effects of blasts. The National Defense Authorization Act for Fiscal Year 2008 specifically directed DVBIC to conduct a 15 year study. Assuring funding of some $40 million specifically for DVBIC would further this goal. Comorbid Conditions As I testified last year, the distinction between TBI and PTSD remains a problem. Some senior DOD medical officers continue to argue that symptoms can be treated without regard to the underlying problem. This is wrong. Treatments for PTSD are often contraindicated for TBI and vice versa. A service member with PTSD may be prescribed a beta blocker to address memory of the trauma, but it unknown how these treatments may affect recovery from TBI. Similarly, a stimulant may be prescribed for TBI to enhance certain brain activity, but stimulants may exacerbate certain symptoms of PTSD. More research must be done to develop evidence-based guidelines for TBI and PTSD, as well as guidelines to address the complexities of comorbid conditions. Education The need continues for greater education and training for TBI specialists, particularly neurologists, physiatrists, neuropsychologists, cognitive rehabilitation specialists and physician assistants, occupational therapists, and physical therapists. For the past 3 years, DVBIC has held annual training sessions for some 800 military medics. Continued funding is also needed for multi-media initiatives, development and dissemination of educational materials for providers, as well as informational tools for injured service members and their families and loved ones. Outreach Congress should continue funding the DVBIC to improve outreach to service members in remote and underserved areas and follow up. Funding is needed to increase the number of case managers as well as expand DVBIC’s TBI Care Coordina- tion program to monitor the continuum of TBI services and connect service members with local and regional TBI-related resources, clinical services, as well as family and patient support services. The IOM recommended that DOD and the Veterans Administration improve coordination and communication among the multitude of programs that have been created to meet the needs of returning service members and veterans. DVBIC coordination with civilian, private and public, resources and services could help fill the gaps in information and referral and service delivery. Greater effort needs to be made to create a safety net so that undiagnosed or misdiagnosed service members do not fall through the cracks. National Guard and Reserves are at particular risk as they often return to their civilian lives. In cases where TBI has been indicated, there have been reports of resistance from military treatment facilities in addressing their needs. A total of $40 million is requested for DVBIC to continue its work and expand and improve as necessary. 548

NICoE Scheduled to open this month, the National Intrepid Center of Excellence is expected to ‘‘use an innovative holistic approach to the referral, assessment, diagnosis and treatment of those with complex psychological health and TBI disorders’’ and serve as ‘‘a global leader in generating, improving, and harnessing the latest advances in science, therapy, telehealth, education, research and technology while also providing compassionate family-centered care for service members and their loved ones throughout the recovery and community reintegration process.’’ (Testimony of Charles L. Rice, MD, Acting Assistant Secretary of Defense for Health Affairs before HASC hearing April 13, 2010). NICoE is to provide neurological and psychological treatment to some 500 service members per year, for whom standard treatment is not successful. NICoE holds much promise, as clinical research can be done like never before. What’s needed is to push the envelope and develop cutting edge rehabilitation efforts for various levels of TBI and then track long term outcomes. As a Center of Excellence, NICoE should lead the way in redefining the standard of care. It is envisioned that NICoE would develop specific treatment plan and then seek out community resources in an injured personnel’s own community. However, funding is needed not only to encourage innovation but to assure that such treatments will be paid for when service members return to their communities, as new treatments will not likely yet be covered by Tricare. In order to provide intensive and innovative rehabilitation, research and coordination with consortia of public and private partners will be necessary. $30 million is needed for pilot projects to treat service members with various levels of TBI, including severe TBI and disorders of consciousness. A total of $45 million for NICoE is requested to be included in the DOD Appro- priations bill for fiscal year 2011 for these purposes. In conclusion, DOD has made some significant strides in addressing the needs of service members with TBI, but more research and innovative treatment is needed. Your leadership and continued support for our wounded warriors is very much appreciated. Thank you for your consideration of this request to help improve the lives of our wounded warriors. Chairman INOUYE. Our next witness is Major General David Bockel, executive director of the Reserve Officers Association of the United States. STATEMENT OF MAJOR GENERAL DAVID BOCKEL, UNITED STATES ARMY (RETIRED), EXECUTIVE DIRECTOR, RESERVE OFFICERS ASSOCIATION General BOCKEL. Mr. Chairman, Mr. Vice Chairman, the Reserve Officers Association thanks you for the invitation to appear and give testimony. I am Major General David Bockel. I am the executive director of the Reserve Officers Association, and I am also authorized to speak on behalf of the Reserve Enlisted Association. A debate is going on whether the Reserve components are becoming too expensive and pricing themselves out of the market as an operational component. It is interesting to note that the argument about the cost of the Reserve and National Guard incentives, benefits, and readiness posture dates back to World War II. At that time, just as now, there were those who said that the Reserve component training, pay, and benefits would be unaffordable and would necessitate long-term costs. As both the Congress and the Pentagon are looking at reducing defense expenses, ROA finds itself again confronted with protecting one of America’s greatest assets, the Reserve components. There are some who would take cuts from the Reserve rather than the Active Duty force. ROA and REA fully understand that when citizen warriors are used for an extended period, there is a substantial personnel cost. It is a cost of war. 549 The statement that, while mobilized, a reservist or guardsman costs as much as an active component member isn’t in dispute. On the other hand, the citizen warrior cost over a lifecycle, being mobilized only when needed and placed into a trained and ready-to-go posture when not recalled, is far less than the cost of an active component warrior. Additional cost savings are found when prior service training develop civilian proficiencies in badly needed military skill sets, are retained by having adequate number of Reserve billets across the spectrum of military missions. National Guard and Reserve members fully understand their duty and are proud to be serving operationally. And not only have they contributed to the war effort, but they have made the difference in maintaining an all-volunteer military force, and in the truest sense, the Reserve components have saved the country from a draft. Establishing parity in training, equipment, pay, and compensation is only fair when the young men and women in the Reserve components are taking their place on the front, assuming the same risk as the Active Duty force. Over 750,000 men and women have left their homes, schools, and workplaces and have performed magnificently in the overseas operational contingencies in Afghanistan and Iraq. The condition of the Reserves and Guard today is different than it was 9 years ago. In ways, it is better, as almost every leader now is a combat-tested veteran. In other ways, however, the condition is worse. Equipment has been destroyed, worn out, or left in the theater. Every defense leader recognizes the need to continue to reset the force. ROA’s written testimony includes lists of unfunded requirements that we hope this subcommittee will fund, but we also urge the subcommittee to specifically identify funding for both the Na- tional Guard and the Reserve components exclusively to train and equip the Reserve components. We hope, too, that this subcommittee continues to provide appropriations for the National Guard and Reserve equipment authorization. Appropriating funds to the Guard and Reserve equipment provides Reserve chiefs and National Guard directors with the flexibility of prioritizing funding. ROA and REA also hope that NGREA dollar levels are assessed based on mission contribution to make it more proportional. Another concern ROA and REA share is legal support for veterans and Guard and Reserve members returning from deployment to face the ever-increasing challenges of reemployment. On June 1, 2009, ROA established the Service Members Law Center. This is a pro bono service that provides legal advice and guidance to Reserve, National Guard, Active, and separated veterans, their families, legal counsel, and as well as providing information to attorneys, bar associations, employers, Members of Congress, and other interested parties. It does not provide legal representation. In just a year, the law center has received over 2,750 requests for information on legal issues. Nearly 60 percent dealt with employment and reemployment rights. The service may be free, but this important service does cost money. Currently, with ROA’s fi- 550 nancial support, it allows the center to be virtually a one-man shop. Awareness of the service outside of ROA membership is only by word of mouth. This does not—there is not any outside promotion. With broader awareness, our vision is to grow and increase the staff and the services provided to our veterans from both Reserve and Active component communities, which will make more money—which will take more money. ROA would appreciate the opportunity to meet with your staff to discuss how this subcommittee can provide monetary support. Thank you again for your consideration of our testimony, and I am available to answer any questions. Chairman INOUYE. I thank you very much, sir. We have got a workload. I can assure you we will do it. Senator COCHRAN. I was just curious about the law center that you mentioned in your testimony, whether or not there is pro bono legal activity. I know when I was practicing law in Mississippi before I came up here to serve in Congress, we had a volunteer legal services program for people who couldn’t afford lawyers, the poor, and we didn’t have as many built-in programs that provide legal services back then. But now there are quite a few. I wonder, are you getting support from local bar associations for this center? General BOCKEL. On a case-by-case basis. The gentleman who runs this law center, his name is Captain (Retired) Sam Wright, Navy Reserve, and he is the source authority on USERRA, Service Member Civil Relief Act, and military voting. When he is invited to speak to bar associations, if they don’t offer an honoraria, he asks for it. Interestingly enough, one of our members of the Reserve Officers Association who is also an attorney is providing an amicus brief to the United States Supreme Court on a case that is going to be heard in the fall. And it is going to be very interesting because it is in I don’t know how many years, it is the first time that a USERRA case has made it that far. Senator COCHRAN. Thank you. Chairman INOUYE. Thank you. [The statement follows:]

PREPARED STATEMENT OF MAJOR GENERAL DAVID BOCKEL The Reserve Officers Association of the United States (ROA) is a professional association of commissioned and warrant officers of our nation’s seven uniformed services, and their spouses. ROA was founded in 1922 during the drawdown years following the end of World War I. It was formed as a permanent institution dedicated to National Defense, with a goal to teach America about the dangers of unprepared- ness. When chartered by Congress in 1950, the act established the objective of ROA to: ‘‘. . . support and promote the development and execution of a military policy for the United States that will provide adequate National Security.’’ The Association’s 65,000 members include Reserve and Guard Soldiers, Sailors, Marines, Airmen, and Coast Guardsmen who frequently serve on Active Duty to meet critical needs of the uniformed services and their families. ROA’s membership also includes officers from the U.S. Public Health Service and the National Oceanic and Atmospheric Administration who often are first responders during national disasters and help prepare for homeland security. President: Rear Admiral Paul Kayye, MC, USNR (Ret.) Staff Contacts: Executive Director: Major General David R. Bockel, USA (Ret.) Legislative Director, Health Care: CAPT Marshall Hanson, USNR (Ret.) 551

Air Force Director: Mr. David Small Army and Strategic Defense Education Director: Mr. ‘‘Bob’’ Feidler USNR, USMCR, USCGR, Retirement: CAPT Marshall Hanson, USNR (Ret.) The Reserve Enlisted Association is an advocate for the enlisted men and women of the United States Military Reserve Components in support of National Security and Homeland Defense, with emphasis on the readiness, training, and quality of life issues affecting their welfare and that of their families and survivors. REA is the only Joint Reserve association representing enlisted reservists—all ranks from all five branches of the military. Executive Director: CMSgt Lani Burnett, USAF (Ret)

PRIORITIES CY 2010 Legislative Priorities are: —Providing adequate resources and authorities to support the current recruiting and retention requirements of the Reserves and National Guard. —Reset the whole force to include fully funding equipment and training for the National Guard and Reserves. —Support citizen warriors, families and survivors. —Assure that the Reserve and National Guard continue in a key national defense role, both at home and abroad. Issues to help Fund, Equip, and Train: —Advocate for adequate funding to maintain National Defense during overseas contingency operations. —Regenerate the Reserve Components (RC) with field compatible equipment. —Fence RC dollars for appropriated Reserve equipment. —Fully fund Military Pay Appropriation to guarantee a minimum of 48 drills and 2 weeks training. —Sustain authorization and appropriation to National Guard and Reserve Equip- ment Account (NGREA) to permit flexibility for Reserve Chiefs in support of mission and readiness needs. —Optimize funding for additional training, preparation and operational support. —Keep Active and Reserve personnel and Operation and Maintenance funding separate. —Equip Reserve Component members with equivalent personnel protection as Ac- tive Duty. Issues to assist Recruiting and Retention: —Support continued incentives for affiliation, reenlistment, retention and continuation in the Reserve Component. Pay and Compensation: —Provide permanent differential pay for Federal employees. —Offer Professional pay for RC medical professionals. —Eliminate the one-thirtieth rule for Aviation Career Incentive Pay, Career En- listed Flyers Incentive Pay, Diving Special Duty Pay, and Hazardous Duty In- centive Pay. Education: —Continued funding for the GI Bill for the 21st Century. Health Care: —Provide Medical and Dental Readiness through subsidized preventive healthcare. —Extend military coverage for restorative dental care for up to 180 days following deployment. Spouse Support: —Repeal the SBP-Dependency Indemnity Clause (DIC) offset.

NATIONAL GUARD AND RESERVE EQUIPMENT ACCOUNTS It is important to maintain separate equipment and personnel accounts to allow Reserve Component Chiefs the ability to direct dollars to needs. Key Issues facing the Armed Forces concerning equipment: —Developing the best equipment for troops fighting in overseas contingency operations. —Procuring new equipment for all U.S. Forces. —Maintaining or upgrading the equipment already in the inventory. —Replacing the equipment deployed from the homeland to the war. —Making sure new and renewed equipment gets into the right hands, including the Reserve Component. Reserve Component Equipping Sources: —Procurement. 552

—Cascading of equipment from Active Component. —Cross-leveling. —Recapitalization and overhaul of legacy (old) equipment. —Congressional adds. —National Guard and Reserve Appropriations (NGREA). —Supplemental appropriation.

END STRENGTH The ROA would like to place a moratorium on reductions to the Guard and Re- serve manning levels. Manpower numbers need to include not only deployable assets, but individuals in the accession pipeline. ROA urges this subcommittee to fund to support: —Army National Guard of the United States, 358,200. —Army Reserve, 206,000. —Navy Reserve, 66,500. —Marine Corps Reserve, 39,600. —Air National Guard of the United States, 106,700. —Air Force Reserve, 71,200. —Coast Guard Reserve, 10,000 In a time of war and the highest OPTEMPO in recent history, it is wrong to make cuts to the end strength of the Reserve Components. We need to pause to permit force planning and strategy to catch-up with budget reductions.

NONFUNDED ARMY RESERVE COMPONENT EQUIPMENT The Army National Guard and Army Reserve have made significant contributions to ongoing military operations, but equipment shortages and personnel challenges continue and if left unattended, may hamper the Reserves’ preparedness for future overseas and domestic missions. In order to provide deployable units, the Army Na- tional Guard and the Army Reserve have cross-leveled large quantities of personnel and equipment to deploying units, an approach that has resulted in growing shortages in non-deployed units. Army Reserve Unfunded Requirements Since 9/11, the Army Reserve has mobilized 185,660 soldiers and currently has about 29,000 deployed. Shortages of equipment on-hand, combined with significant substitute items in the Army Reserve’s inventory, compromise units’ ability to train in support of the modular Army and to meet surge requirements. The Army Reserve has about 73 percent of its required equipment on-hand, but some critical items remain at less than 50 percent fill. Without a higher level of funding, the Army Re- serve is projected to reach 85 percent of its equipment requirements by the end of fiscal year 2015. The Army Reserve has a fiscal year 2015 equipment requirement of $22.05 billion. Under current base budgeting and additional Overseas Contingency Operation funding the projected programmed funds are only $17.76 billion. This is a shortfall of $4.29 billion for the Army Reserve. The minimum NGREA funding to catch-up would be $944 million. Unresourced equipment includes: Transportation: Family of Medium Tactical Vehicles (FMTV)—$1.03 billion Heavy Tactical Vehicle (HTV)—$503 million Heavy Expanded Mobility Tactical Truck (HEMTT–LET)—$300 million Stryker Nuclear Biological and Chemical Recon Vehicle (NBC–RV)—$547 million C–27A Cargo Aircraft—$26 million each —The latest addition to the United States Army Reserve Aviation fleet is the C– 27J Spartan Joint Cargo Aircraft (JCA). The Army Reserve will be initially receiving 16. Tactical Quiet Generators [TQG’s] PU–807A 100kW (3,036)—$5.8 million —The Army Reserve requires 8,717 TQG’s to perform its wartime mission as well as its HLS/HLD responsibilities, but has only 5,681 on-hand. Of particular concern in an unfunded shortfall of 59 100kW power units (PU’s) that exists within Combat Support Hospitals. Army National Guard Unfunded Equipment Requirements Army National Guard (ARNG) units deployed overseas have the most up-to-date equipment available. However, a significant amount of equipment is currently unavailable to the Army National Guard in the states due to continuing rotational deployments and emerging modernization requirements. Equipment is need to replace broken equipment and battle loses, train in pre-mob, support the TPE, and to substitute for equipment in transit. To support the mission the ARNG has cross-leveled 553 equipment. Current equipment procurement averages $5 billion per year. Current equipment levels as of April 2010 are 77 percent of equipment on-hand. HMMWVs (humvees) (2,063)—$2.4 billion —ARNG is critically short on certain HMMWV configurations that are essential to domestic and Overseas Contingency Operations. Transportation—$1.15 billion —FMTV/LMTV Cargo Trucks; HMMWV; HTV 8×8 Heavy Trucks; Tactical Trail- ers. Warfighter Information Network-Tactical (WIN–T)—$1.2 billion —Tactical telecommunications system consisting of infrastructure and network components from the maneuver battalion to the theater rear boundary. The WIN–T network provides Command, Control, Communications, Computers, In- telligence, Surveillance, and Reconnaissance (C4ISR) capabilities that are mobile, secure, survivable, seamless, and capable of supporting multimedia tactical information systems. Stryker combat vehicles, battalion (1)—$1.4 billion —Eight-wheeled vehicle that can travel up to 62.5 mph. It comes in 10 variants, including an infantry-carrier vehicle, a medical evacuation vehicle and a command vehicle. Multi-Temperature Refrigerated Container System (MTRCS)—$7.5 million —The Army National Guard has no refrigerated container systems on-hand, creating a combat readiness issue for selected quartermaster units and forcing states to lease commercial systems to transport food and medical supplies during HLS/HLD missions and during training. The MTRCS is the Army’s new refrigerated container system.

AIR FORCE RESERVE COMPONENTS EQUIPMENT PRIORITIES Air Force Reserve Unfunded Requirements The Air Force Reserve (AFR) mission is to be an integrated member of the Total Air Force to support mission requirements of the joint warfighter. To achieve interoperability in the future, the Air Force Reserve top priorities for unfunded equipment are: Infra-Red Counter Measures C–130 (21)—$63 million —The AN/AAQ–24 (V) NEMESIS is an infrared countermeasure system designed to protect against man-portable (shoulder-launched) infrared-guided surface-to- air missiles. Infra-Red Counter Measures KC–135 (15)—$15 million —KC–135 aircraft deployed in support for Operation Iraqi and Enduring Freedom have inadequate protection against the Infrared Missile threat. For the procurement and installation of the Guardian AN/AAQ–24 (V) Large Aircraft Podded Infrared Countermeasures (LAIRCM) system. Infra-Red Counter Measures C–5B/C–17s (13)—$90 million —For the procurement and installation of the AN/AAQ–24 V NEMESIS, an infrared countermeasure system designed to protect against man-portable (shoulder- launched) surface-to-air missiles. Helmet Mounted Integrated Targeting [HMIT] (39)—$6 million —Upgrade and enhancement to engagement systems. C–5 Structural Repair (6)—$66 million —Stress corrosion cracking of C–5A skins and box beam fittings requires fleetwide replacement to avoid grounding and restriction of outsize cargo-capable to sustain strategic mobility assets. Security Forces Weapons & Tactical Equipment—$5.5 million —Also: The USAFR #1 need is MILCON dollars. Of the total fiscal year 2011 USAF MILCON budget, The AF Reserve was only funded with $3.4 million for its top facilities project, but is underfunded by $1 billion. Air National Guard Unfunded Equipment Requirements Shortfalls in equipment will impact the Air National Guard’s ability to support the National Guard’s response to disasters and terrorist incidents in the homeland. Improved equipping strengthens readiness for both overseas and homeland missions and improves the ANG capability to train on mission-essential equipment. C–17 Globemaster III transport aircraft (5)—$1.3 billion —As highlighted as an ANG airlift requirement. Infra-Red Counter Measures—$238 million —Procure and install LAIRCM systems on C–5, C–17, C–130, 130, HC–130, EC– 130, KC–135 a/c Air Defensive Systems—$49 million 554

—Continue to install ADS systems onto C–5, C–17, and F–15 aircraft. Security Force Equipment—$79.4 million —Crowd control, Tasers, Protective garments, eyewear, goggles, rifles, weapons accessories, traffic control kits, and night vision devices. Helmet Mounted Cueing System (HMCS)—$30 million —The addition of a day/night helmet mounted cueing system (HCMS) will significantly increase pilot situational awareness (SA), aircraft survivability, and lethality in every mission area. Needed for F–16 and A–10 aircraft.

NAVY RESERVE UNFUNDED PRIORITIES Active Reserve Integration (ARI) aligns Active and Reserve component units to achieve unity of command. Navy Reservists are fully integrated into their Active component supported commands. Little distinction is drawn between Active component and Reserve component equipment, but unique missions remain. C–40 A Combo cargo/passenger Airlift (2)—$170 million —The Navy requires a Navy Unique Fleet Essential Airlift Replacement Aircraft. The C–40A is able to carry 121 passengers or 40,000 pounds of cargo, compared with 90 passengers or 30,000 pounds for the C–9. Maritime Expeditionary Security Force—$20 million —Navy Expeditionary Combat Command has 17,000 Navy Reservists and requires $3.1 billion in Reserve Component (Table of Allowance) TOA equipment. KC–130J Super Hercules Aircraft tankers (2)—$168 million —These Aircraft are needed to fill the shortfall in Navy Unique Fleet Essential Airlift (NUFEA). Procurement price close to upgrading existing C–130Ts with the benefit of a long life span. Twenty-four replacements required through 2030. C–37 B (Gulf Stream) Aircraft (1)—$64 million —The Navy Reserve helps maintain executive transport airlift to support the De- partment of the Navy. Civil Engineering Support Equipment—Tactical Vehicles—$4.4 million

MARINE CORPS RESERVE UNFUNDED PRIORITIES More than 54,000 Marine Corps Reservists have executed over 70,000 mobilizations. Nearly one-third of the authorized 39,600 end strength have deployed outside the continental United States. The young men and women have become an experienced combat force, but are limited in their mission by the availability of equipment. KC–130J Super Hercules Aircraft tankers (4)—$200 million or advanced procurement—$48 million —These Aircraft are needed to fill the shortfall in Marine Corps Essential Airlift. USMCR needs 28 airframes, and procurement price close to upgrading existing C–130Ts with the benefit of a longer life span. Commandant, USMC, has testified that acquisition must be accelerated. Light Armored Vehicles—LAV—$1.5 million each —A shortfall in a USMCR light armor reconnaissance company, the LAV–25 is an all-terrain, all-weather vehicle with night capabilities. It provides strategic mobility to reach and engage the threat, tactical mobility for effective use of fire power. Training Allowance (T/A) Shortfalls—$145 million —Shortfalls consist of over 300 items needed for individual combat clothing and equipment, including protective vests, poncho, liner, gloves, cold weather clothing, environmental test sets, took kits, tents, camouflage netting, communications systems, engineering equipment, combat and logistics vehicles and weapon systems. USMCR goal is to ensure that the Reserve TA contains the same equipment utilized by the active component. Obtain latest generation of Individual Combat and Protective Equipment including: M4 rifles; Rifle Combat Optic (RCO) scopes; Light weight helmets; Small Arms Protective Insert (SAPI) plates; Modular Tactical Vests; and Flame Resistant Orga- nizational Gear.

NATIONAL GUARD AND RESERVE EQUIPMENT APPROPRIATION The Reserve components that were once held as a strategic force are now also being employed as an operational asset as well as a strategic reserve; stressing an ever greater need for procurement flexibility as provided by the National Guard and Reserve Equipment Appropriation (NGREA). Much-needed items not funded by the respective service budget are frequently purchased through NGREA. In some cases it is used to bring unit equipment readiness to a needed state for mobilization. The Reserve and Guard are faced with ongoing challenges on how to replace worn out equipment, equipment lost due to combat operations, legacy equipment that is 555 becoming irrelevant or obsolete, and, in general, replacing that which is gone or aging through the abnormal wear and tear of deployment. The Reserve Components benefit greatly from a National Military Resource Strategy that includes a National Guard and Reserve Equipment Appropriation. ROA thanks Congress for approving $750 million for NGREA for fiscal year 2010, but even more dollars are needed. ROA urges Congress to continue the authorization and appropriate for a modern equipment account proportional to the missions being performed, which will enable the Reserve Component to meet its readiness requirements.

SERVICE MEMBERS LAW CENTER The Reserve Officers Association developed a Service Members Law Center, advising Active and Reserve servicemembers who are subject to legal problems that occur during deployment. In almost a year of operation (June 1, 2009 through May 6, 2010), the Service Members Law Center has advised 2,150 individuals, by telephone and/or e-mail, and in a few instances in person. Of those 2,150, approximately 1,720 (80 percent) were Active or Reserve Component (overwhelmingly Reserve Component) members of the Armed Forces. Of those who have contacted us, the ROA Service Members Law Cen- ter has referred about 5 percent to attorneys. The ROA Service Members Law Center has also heard from and has provided information to attorneys, employers, congressional staffers, state legislators and staffers, reporters, and veterans who are not currently Active or Reserve Component members of the Armed Forces but have been in the past. The legal center helps encourage new members to join the Active, Guard and Re- serve components by providing a non-affiliation service to educate prior service about the Uniformed Services Employment and Reemployment Rights Act (USERRA) and Servicemember Civil Relief Act (SCRA) protections, and other legal issues. It helps retention as a member of the staff works with Active and Reserve Component members to counsel those who are preparing to deploy, deployed or recently deployed members facing legal problems. The Legal Center refers names of attorneys who work related legal issues, encouraging law firms to represent service members, and educate and training lawyers, especially active and reserve judge advocates on service member protection cases. The center is also a resource to Congress. The Supreme Court has granted a discretionary review of its first Supreme Court case under (USERRA). The Service Members Law Center will file an amicus curiae (friend of the court) brief in July. ROA sets aside office spaces and has already hired a lawyer to answer questions of serving members and veterans. The goal is to hire two additional staff with a paralegal and an administrative law clerk and provide suitable office equipment and workspace to help man the Service Members Law Center to expand counsel individuals and their legal representatives. Anticipated overall cost fiscal year 2011: $505,000.

CIOR/CIOMR FUNDING REQUEST The Interallied Confederation of Reserve Officers (CIOR) was founded in 1948, and the Interallied Confederation of Medical Reserve Officers (CIOMR) was founded in 1947. These organizations are a nonpolitical, independent confederation of national reserve associations of the signatory countries of the North Atlantic Treaty Organization (NATO). Presently there are 16 member nation delegations representing over 800,000 reserve officers. CIOR supports several programs to improve professional development and international understanding. The Reserve Officers As- sociation of the United States represents the United States and is its member to CIOR. Military Competition.—The CIOR Military Competition is a strenuous 3 day con- test on warfighting skills among Reserve Officers teams from member countries. These contests emphasize combined and joint military actions relevant to the multinational aspects of current and future Alliance operations. Language Academy.—The two official languages of NATO are English and French. As a non-government body, operating on a limited budget, it is not in a position to afford the expense of providing simultaneous translation services. The Academy offers intensive courses in English and French as specified by NATO Military Agency for Standardization, which affords international junior officer members the opportunity to become fluent in English as a second language. Young Reserve Officers Workshop.—The workshops are arranged annually by the NATO International Staff (IS). Selected issues are assigned to joint seminars 556 through the CIOR Defense and Security Issues (SECDEF) Commission. Junior grade officers work in a joint seminar environment to analyze Reserve concerns relevant to NATO. Dues do not cover the workshops and individual countries help fund the events. Presently no Service has Executive Agency for CIOR so that these programs aren’t being funded. Military Competition funding needs at $150,000 per fiscal year.

CONCLUSION The impact of operations in Iraq and Afghanistan is affecting the very nature of the Guard and Reserve, not just the execution of Roles and Missions. It makes sense to fully fund the most cost efficient components of the Total Force, its Reserve Com- ponents. At a time of war, we are expending the smallest percentage of GDP in history on National Defense. Funding now reflects close to 4 percent of GDP including supplemental dollars. ROA has a resolution urging that defense spending should be 5 percent to cover both the war and homeland security. While these are big dollars, the President and Congress must understand that this type of investment is what it will take to equip, train and maintain an all-volunteer force for adequate National Security. The Reserve Officers Association, again, would like to thank the subcommittee for the opportunity to present our testimony. We are looking forward to working with you, and supporting your efforts in any way that we can. Chairman INOUYE. Our next witness is a member of the board of directors of the National Breast Cancer Coalition, Ms. Joy Simha.

STATEMENT OF JOY SIMHA, MEMBER, BOARD OF DIRECTORS, NA- TIONAL BREAST CANCER COALITION AND CO-FOUNDER, YOUNG SURVIVAL COALITION Ms. SIMHA. Thank you. Thank you, Mr. Chairman and members of the Appropriations Defense Subcommittee for the opportunity to testify here today about the Department of Defense Breast Cancer Research Pro- gram. As successful as this competitive peer-reviewed program is, it warrants level funding. I am Joy Simha. I am a 16-year breast cancer survivor, a wife, a mother, and one of the co-founders of the Young Survival Coali- tion and, as you said, a board member of the National Breast Can- cer Coalition. In addition, I sit on the integration panel of the Breast Cancer Research Program with three other survivors and about a dozen scientists. Chairman Inouye and Ranking Member Cochran, we truly appreciate your longstanding support of this innovative, successful program, which represents a meaningful, true way for women to fight breast cancer. Women and their families across the country are depending on this program. The program has a unique structure, which brings scientists, trained consumers, policymakers, and the Army together to collaborate toward ending breast cancer. There is no bureaucracy, and the Army is so efficient and effective in implementing the program. They should be applauded for using less than 10 percent of funds for administrative costs. The program is truly transparent and accountable to the taxpayer. The Era of Hope, which is a biennial meeting where scientists report back on their research results, provides opportunity for others to hear about and collaborate on innovative research re- 557 sults. In addition, all information about who gets funded can be found at the Department of Defense Breast Cancer Web site. The partnership with educated consumers, scientists, the Army, policymakers helps keep the science relevant to women. It ensures the program’s sense of urgency at fulfilling its mission. This program pushes science to new levels. The focus is in changing the status quo by creating new models of research. The collabo- rators are not afraid to ask the very difficult, complex questions and fund unique models of research while maintaining the peer review model. As a true testimony to our success, the mission, the mechanisms, and the structure of the program have been used for models in other programs in other research and scientific research programs. This program has been applauded by the Institute of Medicine and others as an exemplary model of funding research. The program works. It not only saves women’s lives, but it changes the status quo about how we do research. The Department of Defense Breast Cancer Research Program is a true means to an end. People across this country believe in the program and its ability to end breast cancer. I come to you as a survivor representing those people and the many wonderful women we have lost to breast cancer. I wish to dedicate my testimony today to two women who were once chairs of the integration panel who lost their lives recently to breast cancer—Carolina Hinestrosa, who is just about a 1-year—we lost her about 1 year ago, and Karin Noss. We continue our work to honor women as amazing as these two so that we can move forward and try to end breast cancer and save lives in the future. Thank you for your support and the opportunity to testify. Chairman INOUYE. I thank you very much for your testimony. We will do our best. Senator COCHRAN. I want to congratulate you on the quality of your presentation, too. You would be a professional in many, many areas, but particularly the convincing way you presented your remarks I thought was worthy of praise. I noticed that in 2004, there was a report that reviewed this program and gave it very high marks and talked about the scientific breakthroughs that were occurring because of the things that your organization is doing. Congratulations. Ms. SIMHA. Thank you. [The statement follows:]

PREPARED STATEMENT OF JOY SIMHA

INTRODUCTION Thank you, Mr. Chairman and members of the Appropriations Subcommittee on Defense, for the opportunity to submit testimony today about a program that has made a significant difference in the lives of women and their families. I am Joy Simha, a 16-year breast cancer survivor, communications consultant, a wife and mother, co-founder of The Young Survival Coalition, and a member of the board of directors of the National Breast Cancer Coalition (NBCC). I am also a member of the Integration Panel of the Department of Defense Breast Cancer Re- search Program. My testimony represents the hundreds of member organizations and thousands of individual members of the Coalition. NBCC is a grassroots organization dedicated to ending breast cancer through action and advocacy. The Coali- tion’s main goals are to increase Federal funding for breast cancer research and collaborate with the scientific community to implement new models of research; im- 558 prove access to high quality healthcare and breast cancer clinical trials for all women; and expand the influence of breast cancer advocates wherever breast cancer decisions are made. Chairman Inouye and Ranking Member Cochran, we appreciate your longstanding support for the Department of Defense Peer Reviewed Breast Cancer Re- search Program. As you know, this program was born from a powerful grassroots effort led by the National Breast Cancer Coalition, and has become a unique partnership among consumers, scientists, Members of Congress and the military. You and your Committee have shown great determination and leadership in funding the Department of Defense (DOD) peer-reviewed Breast Cancer Research Program (BCRP) at a level that has brought us closer to eradicating this disease. I am hopeful that you and your Committee will continue that determination and leadership. I know you recognize the importance of this program to women and their families across the country, to the scientific and healthcare communities and to the Depart- ment of Defense. Much of the progress in the fight against breast cancer has been made possible by the Appropriations Committee’s investment in breast cancer research through the DOD BCRP. To support this unprecedented progress moving forward, we ask that you support a separate $150 million appropriation, level funding, for fiscal year 2011. In order to continue the success of the Program, you must ensure that it maintain its integrity and separate identity, in addition to level funding. This is important not just for breast cancer, but for all biomedical research that has benefited from this incredible government program.

VISION AND MISSION The vision of the Department of Defense Breast Cancer Research Program is to ‘‘eradicate breast cancer by funding innovative, high-impact research through a partnership of scientists and consumers.’’ The meaningful and unprecedented partnership of scientists and consumers has been the foundation of this model program from the very beginning. It is important to understand this collaboration: consumers and scientists working side by side, asking the difficult questions, bringing the vision of the program to life, challenging researchers and the public to do what is needed and then overseeing the process every step of the way to make certain it works. This unique collaboration is successful: every year researchers submit proposals that reach the highest level asked of them by the program and every year we make progress for women and men everywhere. And it owes its success to the dedication of the U.S. Army and their belief and support of this mission. And of course, to you. It is these integrated efforts that make this program unique. The Department of the Army must be applauded for overseeing the DOD BCRP which has established itself as a model medical research program, respected throughout the cancer and broader medical community for its innovative, transparent and accountable approach. This program is incredibly streamlined. The flexibility of the program has allowed the Army to administer it with unparalleled efficiency and effectiveness. Because there is little bureaucracy, the program is able to respond quickly to what is currently happening in the research community. Because of its specific focus on breast cancer, it is able to rapidly support innovative proposals that reflect the most recent discoveries in the field. It is responsive, not just to the scientific community, but also to the public. The pioneering research performed through the program and the unique vision it maintains has the potential to benefit not just breast cancer, but all cancers as well as other diseases. Bio- medical research is literally being transformed by the DOD BCRP’s success.

CONSUMER PARTICIPATION Advocates bring a necessary perspective to the table, ensuring that the science funded by this program is not only meritorious, but that it is also meaningful and will make a difference in people’s lives. The consumer advocates bring accountability and transparency to the process. They are trained in science and advocacy and work with scientists willing to challenge the status quo to ensure that science funded by the program fill important gaps not already being addressed by other funding agencies. Since 1992, more than 600 breast cancer survivors have served on the BCRP review panels. Last year, Carolina Hinestrosa, a breast cancer survivor and trained consumer advocate, chaired the Integration Panel and led the charge in challenging BCRP investigators to think outside the box for revelations about how to eradicate breast cancer. Despite the fact that her own disease was progressing, she remained steadfast in working alongside scientists and consumers to move breast cancer research in 559 new directions. Unwilling to give up, she fought tirelessly until the end of her life for a future free of breast cancer. Carolina died last year from soft tissue sarcoma, a late side effect of the radiation that was used to treat her breast cancer. She once eloquently described the unique structure of the DOD BCRP: ‘‘The Breast Cancer Research Program channels powerful synergy from the collaboration of the best and brightest in the scientific world with the primary stake- holder, the consumer, toward bold research efforts aimed at ending breast cancer.’’ No one was bolder than Carolina, who was fierce and determined in her work on the DOD BCRP and in all aspects of life she led as a dedicated breast cancer advocate, mother to a beautiful daughter, and dear friend to so many. Carolina’s legacy reminds us that breast cancer is not just a struggle for scientists; it is a disease of the people. The consumers who sit alongside the scientists at the vision setting, peer review and programmatic review stages of the BCRP are there to ensure that no one forgets the women who have died from this disease, and the daughters they leave behind, and to keep the program focused on its vision. For many consumers, participation in the program is ‘‘life changing’’ because of their ability to be involved in the process of finding answers to this disease. In the words of one advocate: ‘‘Participating in the peer review and programmatic review has been an incredible experience. Working side by side with the scientists, challenging the status quo and sharing excitement about new research ideas...it is a breast cancer survivor’s opportunity to make a meaningful difference. I will be forever grateful to the advocates who imagined this novel paradigm for research and continue to develop new approaches to eradicate breast cancer in my granddaughters’ lifetime.’’———Mar- lene McCarthy, two-time breast cancer ‘‘thriver’’, Rhode Island Breast Cancer Coali- tion Scientists who participate in the Program agree that working with the advocates has changed the way they do science. Let me quote Greg Hannon, the fiscal year 3010 DOD BCRP Integration Panel Chair: ‘‘The most important aspect of being a part of the BCRP, for me, has been the interaction with consumer advocates. They have currently affected the way that I think about breast cancer, but they have also impacted the way that I do science more generally. They are a constant reminder that our goal should be to impact people’s lives.’’———Greg Hannon, PhD, Cold Spring Harbor Laboratory

UNIQUE STRUCTURE The DOD BCRP uses a two-tiered review process for proposal evaluation, with both steps including scientists as well as consumers. The first tier is scientific peer review in which proposals are weighed against established criteria for determining scientific merit. The second tier is programmatic review conducted by the Integra- tion Panel (composed of scientists and consumers) that compares submissions across areas and recommends proposals for funding based on scientific merit, portfolio balance and relevance to program goals. Scientific reviewers and other professionals participating in both the peer review and the programmatic review process are selected for their subject matter expertise. Consumer participants are recommended by an organization and chosen on the basis of their experience, training and recommendations. The BCRP has the strictest conflict of interest policy of any research funding program or institute. This policy has served it well through the years. Its method for choosing peer and programmatic review panels has produced a model that has been replicated by funding entities around the world. It is important to note that the Integration Panel that designs this Program has a strategic plan for how best to spend the funds appropriated. This plan is based on the state of the science—both what scientists and consumers know now and the gaps in our knowledge—as well as the needs of the public. While this plan is mission driven, and helps ensure that the science keeps to that mission of eradicating breast cancer in mind, it does not restrict scientific freedom, creativity or innovation. The Integration Panel carefully allocates these resources, but it does not pre- determine the specific research areas to be addressed.

DISTINCTIVE FUNDING OPPORTUNITIES The DOD BCRP research portfolio includes many different types of projects, including support for innovative individuals and ideas, impact on translating research from the bench to the bedside, and training of breast cancer researchers. 560

Innovation The Innovative Developmental and Exploratory Awards (IDEA) grants of the DOD program have been critical in the effort to respond to new discoveries and to encourage and support innovative, risk-taking research. Concept Awards support funding even earlier in the process of discovery. These grants have been instrumental in the development of promising breast cancer research by allowing scientists to explore beyond the realm of traditional research and unleash incredible new ideas. IDEA and Concept grants are uniquely designed to dramatically advance our knowledge in areas that offer the greatest potential. They are precisely the type of grants that rarely receive funding through more traditional programs such as the National Institutes of Health and private research programs. They therefore complement, and do not duplicate, other Federal funding programs. This is true of other DOD award mechanisms also. Innovator awards invest in world renowned, outstanding individuals rather than projects, by providing funding and freedom to pursue highly creative, potentially groundbreaking research that could ultimately accelerate the eradication of breast cancer. For example, in fiscal year 2008, Dr. Mauro Ferrari of the University of Texas Health Science Center at Houston was granted an Innovator Award to develop novel vectors for the optimal delivery of individualized breast cancer treatments. This is promising based on the astounding variability in breast cancer tumors and the challenges presented in determining which treatments will be most effective and how to deliver those treatments to each individual patient. In fiscal year 2006, Dr. Gertraud Maskarinec of the University of Hawaii received a synergistic IDEA Award to study effectiveness of the Dual Energy X-Ray Absorptiometry (DXA) as a method to evaluate breast cancer risks in women and young girls. The Era of Hope Scholar Award supports the formation of the next generation of leaders in breast cancer research, by identifying the best and brightest scientists early in their careers and giving them the necessary resources to pursue a highly innovative vision of ending breast cancer. Dr. Shiladitya Sengupta from Brigham and Women’s Hospital, Harvard Medical School, received a fiscal year 2006 Era of Hope Scholar Award to explore new strategies in the treatment of breast cancer that target both the tumor and the supporting network surrounding it. In fiscal year 2007, Dr. Gene Bidwell of the University of Mississippi Medical Center received an Era of Hope Postdoctoral Award to study thermally targeted delivery of inhibitor peptides, which is an underdeveloped strategy for cancer therapy. One of the most promising outcomes of research funded by the DOD BCRP was the development of the first monoclonal antibody targeted therapy that prolongs the lives of women with a particularly aggressive type of advanced breast cancer. Re- searchers found that over-expression of HER-2/neu in breast cancer cells results in very aggressive biologic behavior. The same researchers demonstrated that an antibody directed against HER-2/neu could slow the growth of the cancer cells that over- expressed the gene. This research, which led to the development of the targeted therapy, was made possible in part by a DOD BCRP-funded infrastructure grant. Other researchers funded by the DOD BCRP are identifying similar targets that are involved in the initiation and progression of cancer. These are just a few examples of innovative funding opportunities at the DOD BCRP that are filling gaps in breast cancer research. Translational Research The DOD BCRP also focuses on moving research from the bench to the bedside. DOD BCRP awards are designed to fill niches that are not addressed by other Fed- eral agencies. The BCRP considers translational research to be the process by which the application of well-founded laboratory or other pre-clinical insight result in a clinical trial. To enhance this critical area of research, several research opportunities have been offered. Clinical Translational Research Awards have been awarded for investigator-initiated projects that involve a clinical trial within the lifetime of the award. The BCRP has expanded its emphasis on translational research by also offering five different types of awards that support work at the critical juncture between laboratory research and bedside applications. The Multi Team Award mechanism brings together the world’s most highly qualified individuals and institutions to address a major overarching question in breast cancer research that could make a significant contribution toward the eradication of breast cancer. Many of these Teams are working on questions that will translate into direct clinical applications. These Teams include the expertise of basic, epidemiology and clinical researchers, as well as consumer advocates. 561

Training The DOD BCRP is also cognizant of the need to invest in tomorrow’s breast cancer researchers. Dr. J. Chuck Harrell, Ph.D. at the University of Colorado, Denver and the University of North Carolina at Chapel Hill, for example, received a Predoctoral Traineeship Award to investigate hormonal regulation of lymph node metastasis, the majority of which retain estrogen receptors (ER) and/or progesterone receptors. Through his research, Dr. Harrell determined that lymph node micro- environment alters ER expression and function in the lymph nodes, effecting tumor growth. These findings led Dr. Harrell to conduct further research in the field of breast metastasis during his postdoctoral work. Jim Hongjun of the Battelle Memo- rial Institute received a postdoctoral award for the early detection of breast cancer using post-translationally modified biomarkers. Dr. John Niederhuber, now the Director of the National Cancer Institute (NCI), said the following about the Program when he was Director of the University of Wisconsin Comprehensive Cancer Center in April, 1999: ‘‘Research projects at our institution funded by the Department of Defense are searching for new knowledge in many different fields including: identification of risk factors, investigating new therapies and their mechanism of action, developing new imaging techniques and the development of new models to study [breast cancer]...Continued availability of this money is critical for continued progress in the nation’s battle against this deadly disease.’’ Scientists and consumers agree that it is vital that these grants continue to support breast cancer research. To sustain the Program’s momentum, $150 million for peer-reviewed research is needed in fiscal year 2011.

OUTCOMES AND REVIEWS OF THE DOD BCRP The outcomes of the BCRP-funded research can be gauged, in part, by the number of publications, abstracts/presentations, and patents/licensures reported by awardees. To date, there have been more than 12,241 publications in scientific journals, more than 12,000 abstracts and nearly 550 patents/licensure applications. The American public can truly be proud of its investment in the DOD BCRP. Scientific achievements that are the direct result of the DOD BCRP grants are undoubtedly moving us closer to eradicating breast cancer. The success of the DOD peer-reviewed Breast Cancer Research Program has been illustrated by several unique assessments of the Program. The IOM, which originally recommended the structure for the Program, independently re-examined the Program in a report published in 1997. They published another report on the Pro- gram in 2004. Their findings overwhelmingly encouraged the continuation of the Program and offered guidance for program implementation improvements. The 1997 IOM review of the DOD peer-reviewed Breast Cancer Research Program commended the Program, stating, ‘‘the Program fills a unique niche among public and private funding sources for cancer research. It is not duplicative of other programs and is a promising vehicle for forging new ideas and scientific breakthroughs in the nation’s fight against breast cancer.’’ The 2004 report spoke to the importance of the program and the need for its continuation. The DOD peer-reviewed Breast Cancer Research Program not only provides a funding mechanism for high-risk, high-return research, but also reports the results of this research to the American people every 2 to 3 years at a public meeting called the Era of Hope. The 1997 meeting was the first time a federally funded program reported back to the public in detail not only on the funds used, but also on the research undertaken, the knowledge gained from that research and future directions to be pursued. Sixteen hundred consumers and researchers met for the fifth Era of Hope meeting in June, 2008. As MSNBC.com’s Bob Bazell wrote, this meeting ‘‘brought together many of the most committed breast cancer activists with some of the nation’s top cancer scientists. The conference’s directive is to push researchers to think ‘out of the box’ for potential treatments, methods of detection and prevention . . .’’ He went on to say ‘‘the program...has racked up some impressive accomplishments in high-risk research projects . . .’’ One of the topics reported on at the meeting was the development of more effective breast imaging methods. An example of the important work that is coming out of the DOD BCRP includes a new screening method, molecular breast imaging, which helps detect breast cancer in women with dense breasts—which can be difficult using a mammogram alone. I invite you to log on to NBCC’s website http:// influence.stopbreastcancer.org/ to learn more about the exciting research reported at the 2008 Era of Hope. The next Era of Hope meeting is being planned for 2011. 562

The DOD peer-reviewed Breast Cancer Research Program has attracted scientists across a broad spectrum of disciplines, launched new mechanisms for research and facilitated new thinking in breast cancer research and research in general. A report on all research that has been funded through the DOD BCRP is available to the public. Individuals can go to the Department of Defense website and look at the abstracts for each proposal at http://cdmrp.army.mil/bcrp/.

COMMITMENT OF THE NATIONAL BREAST CANCER COALITION The National Breast Cancer Coalition is strongly committed to the DOD BCRP in every aspect, as we truly believe it is one of our best chances for finding causes of, cures for, and ways to prevent breast cancer. The Coalition and its members are dedicated to working with you to ensure the continuation of funding for this Pro- gram at a level that allows this research to forge ahead. From 1992, with the launch of our ‘‘300 Million More Campaign’’ that formed the basis of this Program, until now, NBCC advocates have appreciated your support. Over the years, our members have shown their continuing support for this Pro- gram through petition campaigns, collecting more than 2.6 million signatures, and through their advocacy on an almost daily basis around the country asking for support of the DOD BCRP. Consumer advocates have worked hard over the years to keep this program free of political influence. Often, specific institutions or disgruntled scientists try to change the program though legislation, pushing for funding for their specific research or institution, or try to change the program in other ways, because they did not receive funding through the process, one that is fair, transparent and successful. The DOD BCRP has been successful for so many years because of the experience and expertise of consumer involvement, and because of the unique peer review and programmatic structure of the program. We urge this Committee to protect the integrity of the important model this program has become. There are 3 million women living with breast cancer in this country today. This year, more than 40,000 will die of the disease and more than 240,000 will be diagnosed. We still do not know how to prevent breast cancer, how to diagnose it in a way to make a real difference or how to cure it. It is an incredibly complex disease. We simply cannot afford to walk away from this program. Since the very beginning of this Program in 1992, Congress has stood with us in support of this important approach in the fight against breast cancer. In the years since, Chairman Inouye and Ranking Member Cochran, you and this entire Com- mittee have been leaders in the effort to continue this innovative investment in breast cancer research. NBCC asks you, the Defense Appropriations Subcommittee, to recognize the importance of what has been initiated by the Appropriations Committee. You have set in motion an innovative and highly efficient approach to fighting the breast cancer epidemic. We ask you now to continue your leadership and fund the Program at $150 million and maintain its integrity. This is research that will help us win this very real and devastating war against a cruel enemy. Thank you again for the opportunity to submit testimony and for giving hope to all women and their families, and especially to the 3 million women in the United States living with breast cancer and all those who share in the mission to end breast cancer. Chairman INOUYE. Our final witness represents the Program for Appropriate Technology in Health, Dr. John W. Boslego.

STATEMENT OF JOHN W. BOSLEGO, M.D., DIRECTOR, VACCINE DEVEL- OPMENT GLOBAL PROGRAM, PROGRAM FOR APPROPRIATE TECHNOLOGY IN HEALTH Dr. BOSLEGO. Good morning. My name is John Boslego. I am the director of the Vaccine Development Global Program at PATH. I would like to begin by thanking Chairman Inouye and Ranking Member Cochran. I would also like to thank Senators Patty Mur- ray and Dick Durbin for their ongoing championship of global health, and Senator Brownback for his leadership in ensuring access for lifesaving tools for neglected diseases in low-income countries. 563 PATH is an international nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health. By collaborating with diverse public and private sector partners, we help provide appropriate health technologies and vital strategies that change the way people think and act. We wish to take this opportunity to recognize the specific and unique areas of expertise that the Department of Defense brings to bear in advancing innovation that ensures that people in low-resource settings have access to lifesaving interventions and technologies. The global health research effort of DOD responds to diseases many Americans may never see up close, but which military personnel stationed in the developing world experience alongside local communities. PATH requests that in fiscal year 2011 the subcommittee provide robust support for DOD research and development programs aimed at addressing health challenges, particularly for military malaria vaccine research, as well as research at the Defense Advanced Research Project Agency, or DARPA. For malaria vaccine, more than one-third of the world’s population is at risk of malaria, with approximately 250 million cases occurring every year. And most of the nearly 1 million deaths from malaria are among children in Africa under the age of 5. According to a 2006 IOM report, malaria has affected almost all military deployments since the American civil war and remains a severe ongoing threat. The same report noted that a vaccine would be the best method of averting the threat of malaria, given the likely increasing number of deployments to high-risk areas. Military researchers within the Military Infectious Disease Re- search Program are at the forefront of efforts to develop a malaria vaccine. One example of DOD’s impact in malaria research is the most promising vaccine candidate in existence today, RTS,S. Re- search at the Walter Reed Army Institute of Research contributed to the development of the vaccine candidate, and early testing of RTS,S—created by GlaxoSmithKline—was done in collaboration with the U.S. military. Today, thanks to an innovative partnership between GSK Bio and PATH Malaria Vaccine Initiative—a PATH program that works to accelerate development of malaria vaccines and ensure their availability and accessibility in the developing world—RTS,S is now in a large-scale phase 3 trial, typically the last stage of testing prior to licensure. The U.S. Army is assisting in this trial by supporting one of the field sites in Kenya. Unfortunately, current funding levels are nowhere near what is needed to develop urgently needed countermeasures against malaria. PATH recommends $31.1 million in malaria R&D funding for DOD in fiscal year 2011. Another program making great contributions to health research and development is DARPA. DARPA has identified as a priority the development of health technologies that can help both the U.S. military and be of use in DOD-sponsored humanitarian and relief operations in regions emerging from conflict. One of the technologies pioneered by DARPA has led to electrochemical generators of chlorine. PATH has partnered with Cascade 564 Design, Inc., on a new generation of smart electrochlorinators that inactivates bacteria, viruses, and some protozoa to create safe drinking water. The generators can be powered by solar-charged batteries, making them accessible to communities that do not have electricity infrastructure. In conclusion, in light of the critical role that DOD plays in global health research and development, we respectfully request the subcommittee provide the resources to maintain this important core capacity, including $31.1 million in malaria R&D funding. We thank you. Chairman INOUYE. I thank you very much, Doctor, and you may be assured we will seriously consider your request. Senator COCHRAN. Thank you very much. I think malaria is one of those diseases that worldwide is probably the most aggressive and probably causes more deaths and illnesses than any other one malady. Is that right? Is that an accurate assessment? Dr. BOSLEGO. Certainly, it is among the top killers, particularly in Africa. Senator COCHRAN. Well, thank you very much for reminding us of this and your assistance to the subcommittee. [The statement follows:]

PREPARED STATEMENT OF JOHN W. BOSLEGO PATH appreciates the opportunity to submit written testimony regarding fiscal year 2011 funding for global health research and development to the Senate Defense Appropriations Subcommittee. PATH is an international nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health. By collaborating with diverse public- and private-sector partners, we help provide appropriate health technologies and vital strategies that change the way people think and act. We wish to take this opportunity to recognize the specific and unique areas of expertise that the Department of Defense (DOD) brings to bear in advancing innovation that ensures that people in low-resource settings have access to life-saving interventions and technologies. Through DOD, the U.S. Government is able to apply this core capacity to improving health throughout the world. The global health research efforts of DOD respond to diseases many Americans may never see up close, but which military personnel stationed in the developing world experience alongside local communities. Medicines, vaccines, and diagnostics for health threats that disproportionately affect the developing world are critical for their protection. Health is also an important factor in global stability and security. The heavy burden of disease in the developing world hinders economic and social development, which in turn perpetuates conditions that breed political instability. DOD health research therefore benefits not only the U.S. military but also has the potential to reduce this health burden, and by doing so, reduce the likelihood of physical conflict. PATH requests that in fiscal year 2011, the Subcommittee provide robust support for DOD research and development programs aimed at addressing these health challenges, particularly two important programs. First, we request that the Sub- committee provide increased support for military malaria vaccine development efforts. Second, we request that the Subcommittee support research at the Defense Advanced Research and Projects Agency (DARPA) aimed at delivering healthcare to military personnel and civilians in remote, resource-poor, and unstable locations. PATH also requests that no funding cuts be made to DOD research and development. Malaria and Vaccines Malaria is a parasitic infection transmitted by mosquitoes. More than one-third of the world’s population is at risk of malaria, with approximately 250 million cases occurring every year. Most of the nearly 1 million annual deaths from malaria are among children in Africa under the age of five. A malaria vaccine is desperately needed to help prevent these deaths. While consistent use of effective insecticides, 565 insecticide-treated nets, and malaria medicines saves lives, eradicating or even significantly reducing the impact of malaria will require additional interventions, including vaccines. Immunization is one of the most effective health interventions available. Just as it was necessary to use vaccines to control polio and measles in the United States, vaccines are needed as part of an effective control strategy for malaria. Furthermore, vaccines are typically the most efficient means of protecting military personnel from disease threats. When troops are deployed, and particularly under combat conditions, compliance with drug regimens or other disease-protection protocols can be difficult, if not impossible. Vaccination, in contrast, can be performed prior to deployment, and allows deployed personnel to remain focused on mission success, rather than chemoprophylaxis, bed nets, or insecticide application. Malaria and the U.S. Military A 2006 Institute of Medicine (IOM) report 1 found that ‘‘malaria has affected almost all military deployments since the American Civil War and remains a severe and ongoing threat.’’ For this reason, the military has historically taken an active and leading role in the development of health technologies to protect military personnel from malaria, or to treat them if they become infected with the disease. This work includes a robust, cutting-edge program aimed at developing a highly-effica- cious malaria vaccine, suitable for use by military personnel. The aforementioned IOM study noted ‘‘the fact that a vaccine would be the best method of averting the threat of malaria given the likely increasing number of deployments to high-risk areas.’’ An effective vaccine would provide unparalleled protection to servicemen and women serving in malaria-endemic countries and regions, and would significantly reduce the impact of noncompliance, drug resistance, and other significant obstacles that currently limit the military’s ability to provide protection from malaria. Mili- tary researchers within the Military Infectious Disease Research Program, including the U.S. Army Medical Research Institute of Infectious Diseases, U.S. Naval Med- ical Research Center, and the Walter Reed Army Institute of Research (WRAIR), are at the forefront of efforts to develop a malaria vaccine. Research at WRAIR, for example, contributed to the development of the most promising vaccine candidate in existence today, RTS,S. Early testing of RTS,S—created by GlaxoSmithKline Biologicals (GSK Bio)—was done in collaboration with the U.S. military. Today, thanks to an innovative partnership between GSK Bio and the PATH Malaria Vaccine Initiative (MVI)—a PATH program that works to accelerate the development of malaria vaccines and ensure their availability and accessibility in the developing world—RTS,S is now in a large-scale Phase 3 trial, typically the last stage of testing prior to licensure. Although the efficacy of RTS,S is unlikely to prove adequate for military purposes—despite its potential benefit to young children in Africa—it has shown that developing a vaccine against malaria is possible and paved the way for other development efforts that could ultimately allow the military to vaccinate men and women against malaria before deploying them to endemic regions. Since its establishment in 1999, MVI has partnered with the military in a number of malaria vaccine development projects, including the preclinical development of an adenovirus-vectored malaria vaccine candidate developed by GenVec, Inc. that used a modified common cold virus to deliver multiple malaria antigens. Unfortunately, DOD spending on malaria research has been declining for several years from levels that were already comparatively small given the historic impact of malaria on overseas deployments. PATH requests that the Subcommittee reverse this trend, and provide the resources needed to develop the necessary tools—including vaccines—to protect soldiers, sailors, airmen, and marines from this deadly and debilitating disease threat. This would make possible a continuation of the kind of collaboration—characterized by joint funding—that currently exists between MVI and the U.S. Military Malaria Vaccine Program. In particular, PATH recommends $31.1 million in malaria R&D funding for DOD in fiscal year 2011. DARPA and DTRA The Defense Advanced Research Projects Agency (DARPA) is DOD’s primary research and development component and performs work on the cutting edge of multiple scientific disciplines, providing a wide range of critical new technologies and products for use by the military. DARPA has made and could make additional contributions in one area it has identified as a priority: developing health technologies that can both help the U.S. military, and be of use in DOD-sponsored humanitarian relief operations in regions emerging from conflict. Military personnel operating in

1 Battling Malaria—Strengthening the U.S. Military Malaria Vaccine Program. National Acad- emy of Sciences Press, Washington, D.C. 2006. 566 developing countries face many of the same challenges to healthcare delivery as do the residents of those countries: electricity and transportation interruptions that can threaten the integrity of temperature-sensitive medicines and vaccines; lack of access to trained medical personnel and facilities; and an absence of infrastructures and technologies that allow for the rapid manufacture and delivery of medicines and vaccines for the treatment of unexpected infectious disease threats. Increased support for this research would help the United States to more effectively assist developing countries that need vaccines and other basic health technologies, while ensuring that health products are delivered as efficiently as possible. DARPA’s investments in austere healthcare delivery systems—through their focus on disaster medicine in projects such as ‘‘Real World,’’ ‘‘Rapid Altitude Climatization,’’ and ‘‘SAVE II Ventilators’’—represent a commitment to interventions that could have positive and profound health implications for populations in low-resource settings. For example, DARPA pioneered technology that has led to electrochemical generators of chlorine that may be able to fulfill a community’s needs for effective disinfectants for water or surfaces by using just salt water and a simple battery source, such as a car or motorcycle battery. The Smart Electrochlorinator provides a chlorine solution used to treat water from a variety of sources, bringing safe water into small-community households. The devices effectively inactivate bacteria, viruses, and some protozoa to create safe drinking water. Since the generators can be powered by solar-charged batteries, they are accessible to communities that do not have an electricity infrastructure. The only resources required are 75 g of table salt and 0.1 kWh per person per year, both potentially renewable. These costs are significantly less than required for the current large-scale community systems, resulting in break-even points that are within reach of very poor, small communities. PATH has partnered with Cascade Designs, Inc. on a new generation of smart electrochlorinator that has the potential to expand the project initiated by DARPA to broader community reach for both military and civilian benefit. The Defense Threat Reduction Agency (DTRA) is also doing groundbreaking work as it investigates innovations in vaccine and chemical reagent thermo-stabilization and point of care diagnostic tests for infectious diseases that has positive implications for global health and U.S. military support in low-resource settings. Such technologies will enable rapid pathogen identification in the field and threat zone to more rapidly enlist targeted interventions. PATH requests that the Subcommittee maintain funding for the DARPA and DTRA research aimed at developing solutions to these and other health challenges. Conclusion In light of the critical role that at DOD plays in global health research and development, and the fact that investments in this area have been falling, we respectfully request that the Subcommittee provide the resources to maintain this important core capacity. We thank you for your consideration, and hope that you will consider PATH as a resource and partner on this issue.

ADDITIONAL SUBMITTED STATEMENTS Chairman INOUYE. On behalf of the subcommittee, I would like to thank all of you, the witnesses, for the testimony today. The subcommittee has received some additional statements which will be inserted into the record at this point. [The statements follow:]

PREPARED STATEMENT OF THE AMERICAN MUSEUM OF NATURAL HISTORY Overview Recognizing its potential to aid the Department of Defense in its goal to support research to prepare for and respond to the full range of threats, the American Mu- seum of Natural History seeks in $3.5 million in fiscal year 2011 to contribute its unique resources to the advancement of research in areas of science closely aligned with DOD’s research priorities and to extend the research effort with an associated STEM (science, technology, engineering, mathematics) education component, to help build a workforce adequate to meet the nation’s security needs. About the American Museum of Natural History The American Museum of Natural History (AMNH) is one of the nation’s preeminent institutions for scientific research and public education. Since its founding 567 in 1869, the Museum has pursued its mission to ‘‘discover, interpret, and disseminate—through scientific research and education—knowledge about human cultures, the natural world, and the universe.’’ The AMNH research staff numbers over 200, with tenure track faculty carrying out cutting-edge research in fields ranging from molecular biology and genome science to earth and space science, anthropology, and astrophysics. Museum scientists publish nearly 450 scientific articles each year and enjoy a success rate in competitive (peer reviewed) scientific grants that is approximately double the national average. The work of its scientists forms the basis for all the Museum’s activities that seek to explain complex issues and help people to understand the events and processes that created and continue to shape the Earth, life and civilization on this planet, and the universe beyond. Advancing Research Aligned With National Security Goals The Department of Defense (DOD) ensures the nation’s security and its capacity to understand and respond to threats in this new era of complex defense challenges. DOD is committed to the research, tools, and technology that will achieve these goals, and to ensuring that the nation’s 21st century science, technology, engineering, and mathematics (STEM) workforce is prepared to meet U.S. preparedness and security needs. The American Museum of Natural History (AMNH), in turn, is a preeminent research and public education institution, home to leading research programs in bio- computation, comparative genomics, and the life, physical, environmental, and social sciences—programs that are positioned to advance the Nation’s capacity to prepare for and respond to security threats. AMNH is also a recognized leader in STEM education—in both out-of-school settings and with formal education partners—with local, regional, and national reach, and, with the recently launched Richard Gilder Graduate School, became the first American museum authorized to grant the Ph.D. degree. In fiscal year 2005, AMNH and DOD launched a multi-faceted research partnership via DARPA that leverages the Museum’s unique expertise and capacity. Since that time, AMNH has been carrying out research that directly relates to DARPA goals by increasing our capacity to predict where disease outbreaks might occur and to effectively monitor disease-causing agents and their global spread. This research project has been centered on the development of a computational system to rapidly compare genetic sequences of pathogens, and, utilizing the computational system, generating a global map showing the spread of disease-causing viruses over time and place. Throughout this partnership, DARPA program managers have supported AMNH’s work, have made the research known to other DOD-supported scientists, and have invited AMNH scientists to participate in DARPA conferences. With DARPA support to date, the project has: advanced understanding of emerging infectious disease through the analysis of the origins and genomic evolution of SARS coronavirus; studied re-assortment and drug resistance among influenza strains; and developed methods for mapping the spread of pathogens over time and geography. We are now able to track global evolution of pathogenic viruses such as avian influenza, and can identify, for any geographic region, the major and minor sources of pathogenic viruses. The research has investigated progressively more complex systems, moving from viruses to the study of bacteria, including ecological data into the realm of bio- geographical and host-pathogen research. In fiscal year 2011, the Museum seeks DARPA support to advance its research in this and other high-priority areas for the Agency, and to enhance the research program with an associated STEM education component, providing diverse urban students with science content, research experiences, and mentoring in the project’s STEM areas. In so doing, AMNH hopes to help meet the need for a well-educated population of college-level graduates in STEM fields. With this support, which AMNH will leverage with funds from non-Federal and Federal sources, AMNH will be able to continue to draw on its unique research, training, and education capabilities to advance goals critical to DOD and our national preparedness and security.

PREPARED STATEMENT OF FLORIDA STATE UNIVERSITY Summary: Florida State University is requesting $5,500,000 from the Research, Development, Test and Evaluation, Navy, Force Protection Applied Research (PE# 0602123N, Line 5) for the Integration of Electo-kinetic Weapons into the Next Gen- eration Navy Ships Program; $4,000,000 from the Defense, Research, Development, Test and Evaluation, Defense-wide, Government/Industry Co-Sponsorship of Univer- sity Research (PE# 0601111D8Z, Line 3) for the Integrated Cryo-cooled High Power 568

Density Systems; $3,800,000 from the Research, Development, Test and Evaluation, Navy, Defense Research Sciences (PE# 0601153N, Line 3), for the Jet Engine Noise: Understanding and Reduction program, and $4,500,000 from the Research, Develop- ment, Test and Evaluation, Army University and Industry Research Centers Pro- gram (PE# 0601104A, Line 4) for the Nanotubes Optimized for Lightweight Excep- tional Strength (NOLES)/Composite Material Program. Mr. Chairman, I would like to thank you and the Members of the Subcommittee for this opportunity to present testimony before this Committee. I would like to take a moment to briefly acquaint you with Florida State University. Located in Tallahassee, Florida’s capitol, FSU is a comprehensive Research university with a rapidly growing research base. The University serves as a center for advanced graduate and professional studies, exemplary research, and top-quality undergraduate programs. Faculty members at FSU maintain a strong commitment to quality in teaching, to performance of research and creative activities, and have a strong commitment to public service. Among the current or former faculty are numerous recipients of national and international honors including Nobel laureates, Pulitzer Prize winners, and several members of the National Academy of Sciences. Our scientists and engineers do excellent research, have strong interdisciplinary interests, and often work closely with industrial partners in the commercialization of the results of their research. Florida State University had over $200 million this past year in sponsored research awards. Florida State University attracts students from every state in the nation and more than 100 foreign countries. The University is committed to high admission standards that ensure quality in its student body, which currently includes National Merit and National Achievement Scholars, Rhodes and Goldwater Scholars, as well as students with superior creative talent. Since 2005, FSU students have won more than 30 nationally competitive scholarships and fellowships including 3 Rhodes Scholarships, 2 Truman Scholarships, Goldwater, and 18 Fulbright Fellowships. At Florida State University, we are very proud of our successes as well as our emerging reputation as one of the nation’s top public research universities. Our new President, Dr. Eric Barron, will lead FSU to new heights during his tenure. Mr. Chairman, let me summarize our primary interest today. The first project involves improving our nation’s fighting capabilities and is called the Integration of Electro-kinetic Weapons into the Next Generation Navy Ships Project. The U.S. Navy is developing the next-generation integrated power system (NGIPS) for future war ships that have an all-electric platform of propulsion and weapon loads and electric power systems with rapid reconfigurable distribution systems for integrated fight-through power (IFTPS). On-demand delivery of the large amounts of energy needed to operate these types of nonlinear dynamic loads raises issues that must be addressed including the appropriate topology for the ship electric distribution system for rapid reconfiguration to battle readiness and the energy supply technology for the various nonlinear dynamic load systems. The goal of this initiative is to investigate the energy delivery technologies for nonlinear dynamic loads, such as electro-kinetic weapons systems, and investigate the integration and interface issues of these loads on the ship NGIPS through system simulations and prototype tests using power hardware-in-the loop strategies. To meet these research goals, the FSU facilities will be expanded with a 5 MW MVDC power converter and upgrade of the large scale real-time simulator. The results of this effort will provide the Navy’s ship-builders with vital information to design and de-risk deployable ship NGIPS and load power supplies. With significant support from the Office of Naval Research (ONR), FSU has established the Center for Advanced Power Systems (CAPS), which has integrated a real time digital power system simulation and modeling capability and hardware test- bed, capable of testing IPS power system components at ratings up to 5MW, offering unique hardware-in-the-loop simulation capabilities unavailable anywhere in the world. FSU is partnering with Florida Atlantic University, Florida International University, and General Atomics to combine the best talents for modeling and simulation of ship power systems, hardware-in-the-loop testing, power supplies for present and future electro-kinetic systems, and interfacing of the weapon to a ship power system. General Atomics will provide the power requirements for the weapons interface to the shipboard power distribution system. The National High Mag- netic Field Laboratory (NHMFL) will utilize its research expertise and infrastructure for the proposed development. NAVSEA will be an advisor to the project for weapon system integration. We are requesting $5,500,000 for this important program. Our second project is also important to our nation’s defense and involves our Inte- grated Cryo-cooled High Power Density Systems program. The objective of this program is to approach the goal of achieving high power densities through systems in- 569 tegration, management of heat generation and removal in the electrical system and minimize energy consumption and capital expenditures of large scale advanced power systems through cryo-cooled superconducting systems. The research activities are as follows: Systems Analysis.—Extensive system modeling and simulation of the integrated electrical and thermal systems to understand dynamic performance under normal and adverse conditions is necessary to achieve an optimal system configuration. De- velop prototypes of key technologies and test in hardware-in-the-loop simulations at levels of several megawatts (MW) to validate and demonstrate the advanced technologies. Materials—Advanced Conductors, Semi-conductors and Insulation.—Characteriza- tion of conductor materials (both normal and superconducting), semi-conductors (for use in power electronic components) and insulating materials (both thermal and electrical) at cryogenic temperatures to obtain the data needed to model system performance and design components for medium voltage dc (MVDC). Cryo-thermal Systems.—Optimize thermal system options, including conductive heat transfer and gas phase and fluid phase heat transfer systems. Modeling to understand effects from heat leaks from the ambient to the low temperature environment and internal heat generation are critical to successful performance. Adapt- ability to economical fabrication technologies is a major issue for investigation. System Components.—Consider new concepts for design of system components and interfaces to achieve optimum system integration. A 30 meter, 10KV DC cable based on 2G HTS wire will be designed, fabricated and tested to prove the concept of a MVDC superconducting shipboard power distribution system and provide validated design parameters to the Navy. NAVSEA will be a scientific adviser to the project. We are seeking $4,000,000 for this important program in fiscal year 2011. Third, I would like to tell you about our Jet Engine Noise: Understanding and Reduction Program. Engine noise from most modern tactical aircraft is dominated by the jet noise due to the exhaust of very high-speed (supersonic in most cases) gases from the jet engines; this portion of the noise is often referred to as jet noise. Noise levels in the vicinities of these aircraft are extremely high—often as high as 150 dB. This poses considerable risk to the health and safety of the personnel on carrier decks or near aircraft runways. These very high noise levels are also a problem due to their impact on the communities near military bases. If not properly addressed, the jet noise issue will continue to worsen since the noise footprint of future aircraft will likely be much higher due to higher exhaust velocities from their engines. Recently, the Naval Research Advisory Committee (NARC) released a report identifying aircraft exhaust noise as a major problem that requires immediate attention. Under this proposal, FSU proposes a comprehensive program with the short- and long-term goals of (a) developing jet noise suppression technologies that can be ret- rofitted in the current aircraft fleet; (b) undertaking a sustained research effort to better understanding the jet noise sources and fundamentals which will lead to the development of reduction capacities; and (c) to improve noise suppression technologies that will become an integral part of the propulsion systems in future aircraft. This will be achieved by leveraging our significant and unique resources and expertise in the study of jet noise and control. Leveraging resources provided by this program by the State of Florida, FSU will make appropriate improvements to our test and diagnostic facilities to provide the needed fundamental understanding for controlling jet noise. We will use our considerable expertise in Active Flow and Noise Control to rapidly develop and test many of the promising noise control concepts; maturing, then transitioning to the field, the most practical and promising ones. Our team has significant expertise in both the study and control of jet noise and collectively represents some of the best scientists and engineers presently working in this area. Given the interdisciplinary nature of this problem, we are ideally suited to making a notable impact in solving the jet noise suppression problem. We are asking for $3,800,000 to initiate this vital program. Our final project involves Nanotubes Optimized for Lightweight Exceptional Strength (NOLES) Composite Materials. The U.S. Army’s objective of developing effective personnel protection and a lighter, stronger fleet of fighting vehicles may be achieved through the diminutive nanotubes that (1) are the strongest fiber known, (2) have a thermal conductivity two times higher than pure diamond, and (3) have unique electrical conductivity properties and an ultra-high current carrying capacity. For producing lightweight multifunctional composites, resins impregnated with nanotubes hold the promise of creating structures, which will be the strongest ever known, and hence offer maximum personnel and vehicle protection. Benefits are apparent not only to defense, but also throughout the commercial world. 570

Partnered with the Army Research Laboratory, FSU’s team of multi-disciplinary faculty and students has developed unique design, characterization and rapid prototyping capabilities in the field of nano-composite research, leading to vital defense applications. The NOLES research team is developing high performance thermal management materials utilizing nanotubes. The NOLES team is using nanotube composites for shielding against electromagnetic interference. Also, FSU’s composites are being tested for missile wings, UAVs and missile guidance systems by various defense contractors. Three core programs are envisioned for fiscal year 2011: (1) innovative lightweight personnel protection based on integrating cutting-edge technology and commercially available, proven materials for enhanced safety and security of war fighters; (2) developing nanotubes as a material platform and supporting manufacturing processes for a new generation of devices and structures, giving special attention to the design and demonstration for Army and defense applications; and (3) utilizing nanotube buckypaper and optically transparent nanotube thin films initially for liquid crystal display backlighting and eventually for flexible displays. We are seeking $4,500,000 to continue this program in fiscal year 2011. Mr. Chairman, we believe this research is vitally important to our country and would greatly appreciate your support.

PREPARED STATEMENT OF THE INTERSTITIAL CYSTITIS ASSOCIATION Chairman Inouye, Ranking Member Cochran, and distinguished members of the Subcommittee, thank you for the opportunity to discuss Interstitial Cystitis (IC) and to share my story to the Subcommittee. My name is Lauren Snyder, and I am a 29-year-old special needs teacher from Haddon Township, New Jersey. I am also a volunteer with the Interstitial Cystitis Association (ICA), the nation’s foremost nonprofit organization dedicated to improving the quality of life for people living with IC. The ICA provides advocacy, research funding, and education to ensure early diagnosis and optimal care with dignity for people affected by IC. Until the biomedical research community discovers a cure for IC, our primary goal remains the discovery of more efficient and effective treatments to help patients live with the disease. IC is a chronic condition characterized by recurring pain, pressure, and discomfort in the bladder and pelvic region. The condition is often associated with urinary frequency and urgency, although this is not a universal symptom. The cause of IC is unknown. Diagnosis is made only after excluding other urinary and bladder conditions, possibly causing one or more years delay between onset of symptoms and treatment. Men suffering from IC are often misdiagnosed with bladder infections and chronic prostatitis. Women are frequently misdiagnosed with endometriosis, in- flammatory bowel disease (IBD), irritable bowel syndrome (IBS), vulvodynia, and fibromyalgia, which commonly co-occur with IC. When healthcare providers are not properly educated about IC, patients may suffer for years before receiving an accurate diagnosis and appropriate treatment. Although IC is considered a ‘‘women’s disease’’, scientific evidence shows that all demographic groups are affected by IC. Women, men, and children of all ages, ethnicities, and socioeconomic backgrounds develop IC, although it is most commonly found in women. Recent prevalence data reports that 3 to 8 million American women and 1 to 4 million American men suffer from IC. Using the most conservative estimates, at least one out of every 77 Americans suffer from IC, and further study may indicate prevalence rates as high as 1 out of every 28 people. Based on this information, IC affects more people than breast cancer, Alzheimer’s diseases, and autism combined. The effects of IC are pervasive and insidious, damaging work life and productivity, psychological well-being, personal relationships, and general health. Quality of life (QoL) studies have found that the impact of IC can equal the severity of rheu- matoid arthritis and end-stage renal disease. Health-related QoL in women with IC is worse than in women with endometriosis, vulvodynia, or overactive bladder alone. IC patients have significantly more sleep dysfunction, higher rates of depression, increased catastrophizing, anxiety and sexual dysfunction. After sustaining permanent damage to my gastrointestinal tract as the result of salmonella poisoning and developing pelvic floor dysfunction, I underwent a number of surgical procedures that revealed the extent of damage to my bladder. After other conditions were ruled out, I finally received the diagnosis of IC and was able to begin meaning and appropriate treatment. In addition to medications, I receive Botox injections into my pelvic floor, as well as bladder instillations. In my case, these treatments, as well as the multiple surgeries I have undergone, require general anesthesia, hospitalization, and extended recovery time, causing me to miss 571 work and other activities. As a person living with a disability, my work with special needs children is particularly rewarding. Unfortunately, my job requires bending, lifting, and repositioning my students, which is painful and challenging with my IC symptoms. In addition to teaching, I am also a swimming coach, but I have had to reduce my hours as extended exposure to the chlorine in the pool aggravates my bladder. Although IC research is currently conducted through a number of Federal entities, including the National Institutes of Health (NIH) and the Centers for Disease Con- trol and Prevention (CDC), the DOD’s Peer-Reviewed Medical Research Program (PRMRP) remains essential. The PRMRP is an indispensable resource for studying emerging areas in IC research, such as prevalence in men, the role of environmental conditions such as diet in development and diagnosis, barriers to treatment, and IC awareness within the medical military community. Specifically, IC education and awareness among military medical professionals takes on heightened importance, as the President’s fiscal year 2011 budget request does not include renewed funding for the CDC’s IC Education and Awareness Program. On behalf of the ICA, and as an IC patient, I would like to thank the Sub- committee for including IC as a condition eligible for study under the DOD’s PRMRP in the fiscal year 2010 DOD Appropriations bill. The scientific community showed great interest in the program, responding to the initial grant announcement with an immense outpouring of proposals. We urge Congress to maintain IC’s eligibility in the PRMRP in the fiscal year 2011 DOD Appropriations bill, as the number of current military members, family members, and veterans affected by IC increases alongside the general population.

CONCLUSION OF HEARINGS Chairman INOUYE. This subcommittee will take these issues under serious consideration as we develop our fiscal year 2011 De- fense appropriations bill, and this concludes our scheduled hearings for the fiscal year 2011 defense budget. And accordingly, the subcommittee will stand in recess, subject to the call of the Chair. [Whereupon, at 11:56 a.m., Wednesday, June 23, the hearings were concluded, and the subcommittee was recessed, to reconvene subject to the call of the Chair.]

LIST OF WITNESSES, COMMUNICATIONS, AND PREPARED STATEMENTS

Page American Museum of Natural History, Prepared Statement of the ...... 566 Bennett, Senator Robert F., U.S. Senator From Utah: Prepared Statement of ...... 339 Questions Submitted by...... 155, 166, 401, 466 Berman, Colonel Jonathan (Retired), M.D., Ph.D., United States Army Med- ical Corps, on behalf of the American Society of Tropical Medicine and Hygiene ...... 541 Prepared Statement of ...... 543 Bockel, Major General David, United States Army (Retired), Executive Direc- tor, Reserve Officers Association ...... 548 Prepared Statement of ...... 550 Bond, Senator Christopher S., U.S. Senator From Missouri: Questions Submitted by...... 62, 464 Statements of...... 175, 237, 367 Boslego, John W., M.D., Director, Vaccine Development Global Program, Pro- gram for Appropriate Technology in Health ...... 562 Prepared Statement of ...... 564 Brownback, Senator Sam, U.S. Senator From Kansas: Prepared Statement of ...... 29 Questions Submitted by...... 56, 286, 288, 407 Carpenter, Major General Raymond W., Acting Director, Army National Guard, Department of Defense...... 235, 244 Questions Submitted to ...... 289 Summary Statement of ...... 266 Casey, General George W., Chief of Staff, Office of the Secretary, Department of the Army, Department of Defense ...... 1 Prepared Statement of ...... 4 Questions Submitted to ...... 57 Summary Statement of ...... 26 Coane, Rear Admiral Casey, United States Navy (Retired), Executive Direc- tor, Association of the United States Navy ...... 478 Prepared Statement of ...... 479 Cochran, Elizabeth, Secretary, Associations for America’s Defense ...... 533 Prepared Statement of ...... 534 Cochran, Senator Thad, U.S. Senator From Mississippi: Prepared Statement of ...... 338 Questions Submitted by ...... 51, 60, 165, 168, 171, 229, 232, 234, 362, 407, 463 Statements of...... 174, 237, 370, 410, 473 Conway, General James T., Commandant, Marine Corps, Office of the Sec- retary, Department of the Navy, Department of Defense ...... 201 Prepared Statement of ...... 203 Questions Submitted to ...... 232 Davis, John R., Director, Legislative Programs, Fleet Reserve Association ...... 484 Prepared Statement of ...... 485 Debbink, Vice Admiral Dirk J., Chief, Navy Reserve, Department of Defense .. 297 Prepared Statement of ...... 298 Questions Submitted to ...... 331

(i) ii Page Donley, Hon. Michael B., Secretary, Office of the Secretary, Department of the Air Force, Department of Defense ...... 365 Prepared Statement of ...... 372 Questions Submitted to ...... 395 Summary Statement of ...... 370 Dorgan, Senator Byron L., U.S. Senator From North Dakota: Prepared Statement of ...... 338 Questions Submitted by...... 156, 360 Statement of ...... 368 Elkas, John C., M.D., J.D., on behalf of the Society of Gynecologic Oncolo- gists ...... 520 Prepared Statement of ...... 521 Feinstein, Senator Dianne, U.S. Senator From California, Questions Sub- mitted by ...... 284, 361, 459 Flaherty, Rear Admiral Karen, Director, Navy Nurse Corps, Department of the Navy, Medical Health Programs, Department of Defense ...... 140 Prepared Statement of ...... 119 Questions Submitted to ...... 166 Florida State University, Prepared Statement of ...... 567 Gates, Hon. Robert M., Secretary of Defense, Office of the Secretary, Depart- ment of Defense ...... 409 Prepared Statement of ...... 413 Questions Submitted to ...... 455 Summary Statement of ...... 411 Gooden, H. James, Chairman, Board of Directors, American Lung Association 473 Prepared Statement of ...... 475 Green, Lieutenant General (Dr.) Charles B., Surgeon General, Department of the Air Force, Medical Health Programs, Department of Defense ...... 84 Prepared Statement of ...... 86 Questions Submitted to ...... 156 Horoho, Major General Patricia, Chief, Army Nurse Corps, Department of the Army, Medical Health Programs, Department of Defense ...... 138 Prepared Statement of ...... 110 Hutchison, Senator Kay Bailey, U.S. Senator From Texas, Questions Sub- mitted by ...... 400, 465 Inouye, Chairman Daniel K., U.S. Senator From Hawaii: Opening Statements of ...... 1, 65, 173, 235, 337, 365, 409, 473 Questions Submitted by ...... 43, 57, 146, 156, 166, 169, 227, 230, 232, 282, 287, 289, 331, 333, 334, 359, 395, 404, 455, 468 Interstitial Cystitis Association, Prepared Statement of the ...... 570 Jones, Richard A., Legislative Director, National Association for Uniformed Services ...... 525 Prepared Statement of ...... 527 Kelly, Lieutenant General John F., Commander, Marine Forces Reserve and Marine Forces North, Department of Defense ...... 305 Prepared Statement of ...... 306 Questions Submitted to ...... 333 Kohl, Senator Herb, U.S. Senator From Wisconsin, Questions Submitted by ... 398 Leahy, Senator Patrick J., U.S. Senator From Vermont: Questions Submitted by...... 46, 57, 152, 397, 406, 459, 469 Statement of ...... 368 Mabus, Hon. Ray, Secretary of the Navy, Office of the Secretary, Department of the Navy, Department of Defense ...... 173 Prepared Statement of ...... 178 Questions Submitted to ...... 227 Summary Statement of ...... 176 Mason, Karen, Registered Nurse, Ovarian Cancer National Alliance ...... 494 Prepared Statement of ...... 495 iii Page McConnell, Senator Mitch, U.S. Senator From Kentucky, Questions Sub- mitted by ...... 53, 465 McHugh, Hon. John M., Secretary, Office of the Secretary, Department of the Army, Department of Defense ...... 1 Prepared Statement of ...... 4 Questions Submitted to ...... 43 Summary Statement of ...... 3 McKinley, General Craig R., Chief, National Guard Bureau, Department of Defense ...... 235 Prepared Statement of ...... 240 Questions Submitted to ...... 282 Summary Statement of ...... 238 Mikulski, Senator Barbara A., U.S. Senator From Maryland, Questions Sub- mitted by ...... 153, 159 Mullen, Admiral Mike, U.S. Navy, Chairman, Joint Chiefs of Staff, Depart- ment of Defense ...... 409 Prepared Statement of ...... 423 Questions Submitted to ...... 468 Murray, Senator Patty, U.S. Senator From Washington: Questions Submitted by...... 47, 58, 148, 161, 170, 461, 471 Statement of ...... 370 O’Reilly, Lieutenant General Patrick J., Director, Missile Defense Agency, Department of Defense ...... 337 Prepared Statement of ...... 342 Summary Statement of ...... 339 Putka, Dan, Ph.D., on behalf of the American Psychological Association ...... 516 Prepared Statement of ...... 517 Rentfrow, Kathy, Volunteer, Dystonia Medical Research Foundation ...... 481 Prepared Statement of ...... 483 Robinson, Vice Admiral Adam M., Jr., Surgeon General, Department of the Navy, Medical Health Programs, Department of Defense ...... 65 Prepared Statement of ...... 69 Questions Submitted to ...... 146 Summary Statement of ...... 66 Roughead, Admiral Gary, Chief of Naval Operations, Office of the Secretary, Department of the Navy, Department of Defense ...... 183 Prepared Statement of ...... 185 Questions Submitted to ...... 230 Savant, Katie, Government Relations Deputy Director, National Military Family Association ...... 498 Prepared Statement of ...... 500 Schoomaker, Lieutenant General Eric B., M.D., Ph.D., Surgeon General; and Commander, U.S. Army Medical Command, Department of the Army, Med- ical Health Programs, Department of Defense ...... 76 Prepared Statement of ...... 78 Questions Submitted to ...... 156 Schwartz, General Norton A., Chief of Staff, Department of Defense ...... 381 Questions Submitted to ...... 404 Shelby, Senator Richard C., U.S. Senator From Alabama: Question Submitted by ...... 363 Statement of ...... 3 Simha, Joy, Member, Board of Directors, National Breast Cancer Coalition and Co-Founder, Young Survival Coalition ...... 556 Prepared Statement of ...... 557 Siniscalchi, Major General Kimberly, Assistant Surgeon General for Nursing Services, Air Force Nurse Corps, Department of the Air Force, Medical Health Programs, Department of Defense ...... 143 Prepared Statement of ...... 123 Questions Submitted to ...... 169 Stenner, Lieutenant General Charles E., Jr., Chief, Air Force Reserve, De- partment of Defense ...... 315 Prepared Statement of ...... 317 Questions Submitted to ...... 334 iv Page Stultz, Lieutenant General Jack C., Chief, Army Reserve, Department of Defense ...... 291 Prepared Statement of ...... 292 Questions Submitted to ...... 331 Sumrall, Major General Michael H., Acting Director, Joint Staff, National Guard Bureau, Department of Defense ...... 254 Wicks, Terry C., Certified Registered Nurse Anesthetist, MHS, American Association of Nurse Anesthetists ...... 489 Prepared Statement of ...... 490 Wyatt, Lieutenant General Harry M., III, Director, Air National Guard, De- partment of Defense ...... 235, 250 Questions Submitted to ...... 287 Summary Statement of ...... 265 Zitnay, George A., Ph.D., Co-Founder, Defense and Veterans Brain Injury Center ...... 544 Prepared Statement of ...... 545 SUBJECT INDEX

DEPARTMENT OF DEFENSE

DEPARTMENT OF THE AIR FORCE

OFFICE OF THE SECRETARY

Page Additional Committee Questions ...... 395 Agile Combat Support ...... 379 Air Force: Five Priorities ...... 381 Military Construction ...... 389 Air Superiority ...... 374 Building Partnerships ...... 378 Command and Control ...... 378 Cyberspace Superiority ...... 375 C–130 Training ...... 386 4.5 Generation Fighter ...... 385 Four Objectives in 2010 QDR ...... 370 F–15E Radar Modernization ...... 384 F–35 Aircraft for Lackland AFB, Texas ...... 401 Global: Intelligence, Surveillance, and Reconnaissance ...... 377 Precision Attack ...... 375 Joint Strike Fighter Unit Costs ...... 388 KC–X Basing ...... 390 Leasing Unmanned Aerial Vehicles ...... 383 Long Range Persistent Strike Development Program ...... 401 Maintenance in the Air Force ...... 400 NASA and Solid Rocket Production ...... 392 Newer Aircraft for Texas Air National Guard ...... 401 Nuclear Deterrence Operations ...... 373 Personnel Recovery ...... 378 Rapid Global Mobility ...... 376 Readiness and Resourcing ...... 380 SBIRS Payloads ...... 383 Space Superiority ...... 374 Special Operations ...... 377 Strategic Focus ...... 372 Strategy to Resources ...... 373 Summary ...... 380 World Trade Organization Ruling in Tanker Competition ...... 391, 393 Year of the Air Force Family ...... 371

DEPARTMENT OF THE ARMY

OFFICE OF THE SECRETARY Additional Committee Questions ...... 43 America’s Army—The Strength of the Nation ...... 15 Armed: Aerial Scout Helicopter ...... 44 Scout Helicopter ...... 51 Army: Funds Running Out in Fiscal Year 2010 ...... 45

(v) vi Page Army—Continued Guard and Reserve Equipment ...... 46 Unmanned Aerial Vehicles ...... 60 Bad Contracts ...... 41 Behavioral Health ...... 30 Blue Grass Army Depot ...... 56 Brigade Combat Team ...... 55 Modernization...... 43, 52, 61 Character of Conflict in the 21st Century ...... 6 Comprehensive Soldier Fitness and Mental Health ...... 58 Contracting Capability ...... 42 Counseling Services ...... 54 Director of the Army Guard ...... 46 Duplication of System ...... 39 Equipment in Theater ...... 57 Families ...... 49 Future Role of MRAP Vehicles ...... 44 Global Trends ...... 5 Homeland Response Force ...... 46 Hospital ...... 54 Housing Barracks ...... 55 Joint Cargo Aircraft ...... 45 Mental Health ...... 58 Mi-17 Helicopter ...... 35 Military Construction ...... 63 Mine Resistant Ambush Protected (MRAP) Vehicles...... 53, 61 Modernize the Force ...... 62 Modernizing ...... 28 Modularity and Rebalance ...... 27 National Guard and Reserves ...... 47 New Military/VA Hospital ...... 38 PTSD/TBI ...... 55 Persistent Conflict ...... 5 Recapitalization ...... 57 Recruitment ...... 32 Reset of Army Equipment ...... 61 Resiliency of the Force ...... 51, 61 Response to Bad Contracts ...... 42 Restoring Balance/Risk ...... 60 Restoring Balance: The Army’s Four Imperatives ...... 7 Roles of Land Forces ...... 6 Schools ...... 56 Setting Conditions for the Future ...... 10 Stewardship and Innovation ...... 14 Strategic Context ...... 5 Stress on the Force ...... 30 Stryker ...... 32, 33 V Hulls ...... 59 Suicide ...... 31 Prevention ...... 38 Suicides ...... 53 Tactical Radios ...... 45 Title 32 Line Item ...... 47 Transients, Trainees, Holdees and Students (TTHS) Account ...... 63 Two Critical Challenges ...... 7 Unmanned Aerial Vehicles ...... 35

DEPARTMENT OF THE NAVY

OFFICE OF THE SECRETARY Acquisition Excellence ...... 181 Additional Committee Questions ...... 226 Amphibious Warfare Ships ...... 193 Aviation ...... 221 Programs ...... 188 Build Tomorrow’s Navy ...... 187 Develop and Support our Sailors, Navy Civilians and their Families ...... 198 vii Page Energy Reform ...... 181 Information Dominance Programs ...... 194 Iraq and Afghanistan ...... 205 Littoral Combat Ship ...... 223 Marine Corps: Recruiting and Retention ...... 217 Reset/Reconstitution ...... 217 Modernization of the MAGTF ...... 211 President’s Budget Request ...... 215 Readiness ...... 205 Remain Ready to Fight Today ...... 195 Ship Count ...... 216 Mission Requirements ...... 220 Submarine Programs ...... 192 Suicides ...... 216 Surface Ship Programs ...... 190 Taking Care of Sailors, Marines, Civilians, and their Families ...... 180 Technology ...... 218 Unmanned Systems ...... 182 Vision ...... 212 Women on Submarines ...... 226 Your Marine Corps ...... 203

MEDICAL HEALTH PROGRAMS Additional Committee Questions ...... 146 Air Force Nursing Research Initiatives ...... 170 Behavioral Health Providers ...... 166 Build Patient-Centered Care and Focus on Prevention to Optimize Health ...... 88 CBOC ...... 146 Caring for: Our Heroes ...... 71 Wounded, Ill and Injured ...... 134 Cervical Cancer ...... 160 Chiropractic Care ...... 166 Chiropractors ...... 155 At MTFs ...... 155 Civilian Nurse Transition Programs ...... 169 Community Based Primary Care Clinics ...... 156 Concept of Care ...... 71 Critical Warfighting-skill Bonuses ...... 92 Defense Centers of Excellence ...... 152 Chain of Command for Installation Repairs ...... 147 Department-Wide Nurse Residency Program ...... 167 Evidence-based Practice: Optimize Performance ...... 114 Excellence in Research and Development (R&D) ...... 74 Expeditionary: Medicine and Humanitarian Assistance ...... 87 Nursing ...... 124 Family Readiness and Support ...... 162 Force Health Protection ...... 70 Funding a World Class Facility ...... 147 Health Professions Scholarship Program ...... 158 Hearing Center of Excellence ...... 157 Human Capital: Portfolio of Talent ...... 116 Humanitarian ...... 126 Assistance and Disaster Response ...... 70 Information Management/Information Technology ...... 87 Investing in Our People: Education, Training, and Research ...... 90 Joint: Medical Policies ...... 169 Venture Keesler-Biloxi Medical System ...... 165 Leader Development: Build our Bench ...... 111 Mental Health: Assets and Services for Families ...... 150 Awareness...... 106, 149, 161 Care ...... 164 Professionals ...... 153 viii Page Mental Health—Continued Stigma ...... 151 Mental Healthcare for Reserve Component ...... 103 National Guard and Reserves ...... 104 Navy: Medicine: Interaction with Safe Harbor ...... 147 Use of Software ...... 152 Nurse: Challenges at FHCC ...... 167 Corps Collaboration with VA ...... 168 Recruiting Mechanisms ...... 167 Nurse: Corps: Contributions ...... 170 Promotions ...... 159 Retention ...... 170 Recruiting ...... 148 Resiliency ...... 169 Operational Currency ...... 127 Organizational Structure ...... 130 Our: Leadership ...... 123 People ...... 119 Practice ...... 121 O–7: Air Force Nurse Corps Billet ...... 169 And O–8 Nurse Corps Billets ...... 146 Partnerships and Collaboration ...... 74 Psychological Health and Post-Traumatic Stress ...... 72 Recruiting: And Retaining Officers ...... 101 And Retention ...... 127 Bonuses ...... 92 Civilian Providers ...... 99 For the Reserves ...... 148 Recruitment of Mental Health Professionals ...... 159 Rehabilitation for Wounded Warriors ...... 93 Research ...... 130 Reserve Components ...... 164 Resiliency in the Force...... 168, 171 Skills Sustainment ...... 129 Strategies for the Future ...... 133 Suicide Prevention...... 105, 136 Supporting Families and Children ...... 108 The Navy Medicine Team ...... 74 The Way Forward ...... 75 Transforming Expeditionary Medicine and Aeromedical Evacuation Capabili- ties ...... 87 Transition of Wounded Warriors to the VA ...... 151 Traumatic Brain Injury ...... 73 VA Sharing Agreements ...... 154 Value of Combat Medics ...... 100 Walter Reed National Military Medical Center ...... 94 Warrior Care: Back to Basics ...... 112 Way Ahead ...... 134 Wilford Hall Closure ...... 158 Women’s Health: Cervical Cancer ...... 153 Wounded Warrior Care ...... 163 Year of the Air Force Family ...... 90

MISSILE DEFENSE AGENCY Additional Committee Questions ...... 358 Aegis: And GMD Competition ...... 350 Standard Missile Acquisition ...... 359 Airborne Laser Program ...... 352 ix Page Cruise Missile Defense ...... 353 Defense Against Regional Threats ...... 343 Defense of the Homeland Against Limited Attack ...... 342 Develop New, Fiscally Sustainable Capabilities Over the Long Term ...... 347 European Land-based versus Sea-based Defense ...... 357 Expand International Missile Defense Cooperation ...... 347 GBI Numbers and Testing ...... 349 Hedging Against Threat Uncertainty ...... 346 Israeli Cooperative Program Support ...... 362 Land-based Aegis ...... 358 Missile Defense Strategy—European Defense ...... 354 NATO—Active Layered Theater Ballistic Missile Defense ...... 362 Partnership With Japan ...... 349 Phased Adaptive Approach—Aegis ...... 348 Proving the Ballistic Missile Defense System Works ...... 345 Russia and the START Treaty ...... 355 SM–3: Cost ...... 350 Missile Gap ...... 363 START Treaty ...... 357 And: Iranian Threat ...... 351 Limits to Response ...... 352 United States and Russia Cooperation ...... 356 Sea-based Assets ...... 362 The New START Treaty ...... 341 Theater High Altitude Area Defense (THAAD) ...... 359

NATIONAL GUARD Additional Committee Questions ...... 282 Air National Guard: Aging Fleet ...... 269 Fighter Shortfall ...... 287 Recruiting and Retention ...... 288 America’s Exceptional Force, Home and Away ...... 250 Army and Air Guard—Equipment ...... 282 Best Value for America ...... 250 Blackhawk Helicopters ...... 286 C–130 ...... 275 Force Structure Changes ...... 287 Domestic Operations ...... 254 Equipment Readiness ...... 248 Facilities and Military Construction ...... 248 Families ...... 279 Family Support and Yellow Ribbon Programs ...... 283 Future Plans—Our Vision ...... 243 Health Assessments ...... 280 In Memoriam ...... 259 Introduction and Executive Overview ...... 240 Joint and Interagency Training ...... 257 Message from the Director ...... 244, 250, 254 Military Construction ...... 284 NGB as a Joint Activity ...... 243 National Guard Equipment ...... 272 Operational Force ...... 277 Operations ...... 244 Personnel Strength and Quality Programs ...... 246 Present and Future Value ...... 246 Protecting America’s Future ...... 252 Rapid Evolution ...... 240 Readiness ...... 241 State Adjutants General ...... 259 Suicide ...... 275 Supporting the Warfighter and Family ...... 258 Training and Technology ...... 249 UH–60 Black Hawk Upgrades ...... 289 Vigilant Guard ...... 257 x Page OFFICE OF THE SECRETARY Additional Committee Questions ...... 454 Advocacy Programs ...... 423 Afghanistan ...... 437 Alternate Engine ...... 433 Balancing Global Strategic Risk ...... 429 Budget Submission ...... 421 Care for Our All-Volunteer Force ...... 414 China ...... 447, 455, 469 C–17s ...... 435 Defend our Interests in the Broader Middle East and South/Central Asia ...... 425 Defense Department Spending ...... 457 Focus on Yemen and Somalia ...... 452 Force Structure ...... 434 Global Defense Posture ...... 465 Health of the Force ...... 427 Healthcare: Costs ...... 459 Projections ...... 433 Impact of: Changing Health Benefits on Service Members ...... 468 Program Terminations ...... 456 Iran to Develop Nuclear Weapon ...... 439 Iridium Constellation Replenishment ...... 455 Israeli-Palestinian Conflict ...... 440 Joint Strike Fighter ...... 432 Key Developments ...... 424 Marjah ...... 441 Military Campaign in Kandahar ...... 446 National Interdiction Unit ...... 451 New Government in Iraq ...... 443 Rebalancing the Force: Preparing for the Future ...... 416 The Wars We Are In ...... 415 Reforming How DOD Does Business ...... 418 Security Outposts ...... 422 Ships for Navy ...... 443 Solid Rocket Motors ...... 449 Somalia...... 455, 457, 468 South Korea ...... 466 Supplemental ...... 444 Temporary Task Forces ...... 458

RESERVES Additional Committee Questions ...... 330 Air Force Reserve: Manpower ...... 323 Modernization ...... 323 Retention ...... 334 Broaden Total Force Initiative Opportunities ...... 322 Care for our Warrior Force ...... 299 Career Intermission Pilot Program ...... 332 Casualty Assistance and Military Funeral Honors ...... 315 Continuum of Service ...... 331 Equipment ...... 310 Facilities ...... 312 Health Services ...... 313 Integration With Active Forces ...... 328 Maintain a Strategic Reserve While Providing an Operational, Mission Ready Force ...... 320 Marine Corps Reserve—Strain on the Force ...... 333 Military Construction (Milcon) and Infrastructure Modernization ...... 324 Navy and Marine Corps Reserve Officer Recruiting ...... 332 Personnel ...... 308 Preserve the Care and Viability of the Reserve Triad ...... 321 Progress in Programs for our People ...... 300 xi Page Quality of Life ...... 314 Recruiting and Retention...... 318, 324 Today’s Marine Corps Reserve ...... 307 Training ...... 311 Transition to Operational Reserve ...... 331 Way Ahead ...... 303 Æ